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0055 AIRPORT ROAD - HAZMAT
9 -o I -av/ Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire .---------------------------------------------------------------------------------------------------------------------------- 55 Airport Road, Hyannis, MA ..---------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health -jet � • • 7I 1 tf Town of Barnstable Inspectional Services BARNSTABLE Public Health Division " ' Thomas McKean,Director s,�ararasu�. te19 200 Main Street,Hyannis,MA 02601 Office. 508.862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE �I, A RDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 109, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26-110 Gallons: $ 50.00 13 CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 1/Si CATEGORY 3 PERMIT 500 or ingm Gallons: $150.00 Pd Cal *A late charge of 110.00 will be assc sW if ayment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ' YES,NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5�m-,l-4 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: ,`"r ,�1✓1� 2"+7 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: LI( 4eC oAd ✓AAit ndi c, LkVkk ' 8. TELEPHONE NUMBER OF ESTABLISHMENT: SSO 0 L 9. EMAIL ADDRESS: &A 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: %N C_ 11. FULL NAME,HOME ADDRESS,AND TELEfHONE#OF: CORPORATION NAME j, u 11, rrt a h-fly_ i•c- PRESIDENT TREASURER /1 CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE_ /_ /rD- �0,,o Q:1App1izion Fmt u\liu Met Appli DaftJm2019.d0Cx • 1- i • • • t. T Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis,MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------------------------------------------------- ----------------------------------------------------------------------------------- --------------------------- ------------------------- --------------------------- -----------------------------------_------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health Town of Barinstable �� . Inspectional Services BARNS LE ' .. O�.tHE}h,-'t•O :... ... • � ,- wx"s+°�is"Bafti�.os�+�°IV�iie �°e�nT°m�F � -Y • Public Health'Division �iwe-:mta Thomas McKean, Director prEo. ,a 200:IVlatn Street,Hyannis,MA.02601 Office. 508-862 4G44 Fax: 508490-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE 0 HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN..OF.BARNS.T'ABLE GENERAL ORDINANCE;,CHAPTER 108, HAZARDOUS MATERIALS;ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 19t=:JU 1E 30th), APPLICATION FEES: .. CATEGQR'1.:PERIVIIT_. 26 11O Gal:lons. .; $ 50,00 CATEGORY 2 PERMIT 111 —499 Gallons:. $1L5:00 [ -- CATEGORY 3 PERMIT 500 or more Gallons: $150.00 �-�' *A late charke of$10.0.0 will be assessed.if payment is not received by July 1st. 1. ASSESSOR'S"MAP AND PARCEL NO Z IS THIS:A PERMIT RENEWAL? YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMITAPPLICATIONS,INDICATE'WHETHER BUSINESS HAS ZONING/BUILDING=APPROVAL FOR HAZARDOUS MATERIALS STO.RAGEIUSE.OF_.._ GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)?. . YES NO. 4. FULL NAI4E.OF APPLICANT;. ,ScoA, 'Mc 1 5 NAME OF,ESTABLISEOMNT: VA k)�'T;d! .6. ADDRESS OF ESTABLISHMENT:'�rh- ►y on.f. 41. 7•. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:" qI A ccoLlci Pmk rwtt l A 4 'S w 8. ;TELEPHONE NUMBER OF ESTABLISHiVIENT �� — "77�" dU� �✓ 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO.IF NO,NAME OF PARTNER: .0 L,, 11. FULL NAME,HOME ADDRESS,AND TELEPHONE'#OF:CORPORATION NAME NAME .!cLA\S ;VA r A� ism ° P)RESIDENT TREASURER CAS CLERK' 12. IF PREPARED.BY OUTSIDE PARTY: NAM . E: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICAN/-i8.dorx ` DATE -. h- Q 1Applicadon Forms\Haz Mat AppRevised,09- . Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Vofow1� B nsxable �� 1�glf? egulatory Services �s r Richard V. Scali,Director Public Health Division BARNSTABLEmoNHABLEb • • ennsne .ra +wF.mrurt•wraas • Thomas McKean,DirectorMAS& 1630-2014 a ATEo ,�a 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 -o APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS a IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, " HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $I50.00 V s *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BVILDING APPROVAL FOR HAZARDOUS-MATERIALS STORAGE/USE OF • GREATER;THAN HOUSEHOLD QUANTITIES (25.GALLONS)? YES NO. 4. -FULL NAME OF APPLICANT: .4 98AK of 5. NAME OF ESTABLISHMENT: �(�,��,,,yA*J `� 6. ADDRESS OF ESTABLISHMENT:SS- ft�k y 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: Q. Ww*M vz(A 8. TELEPHONE NUMBER OF ESTABLISHMENT: --7?'S7-6T,L 9. EMAIL ADDRESS: ( wWJT_,) �Xwt. cbrn 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME &A,&V w T A-t PRESIDENT tAt N --------TREASURER-- � � E' -` C-C � -- --C'CON - - — -- -= - 12. IYPREPARED=BY OUTSIDE PARTY: r NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: •• i SIGNATURE OF APPLICANT DATE,'"_/r//% Q:\Application FormsUiAZMAT APP 2017 RE ocx INE►ok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"Mq� `e.� 200 Main Street• Hyannis, MA 02601 "rEO59.+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: w ��v'�^ti «- Date: s 3 6 Location/Mailin Address: ss ► t-< aT-� s Contact Name/Phone: Jv .5o8 gog-y"O N oo Scn�QQ�PI �o�'�• .� jtGtoA,fTly* InventoryTotal Amount: SDS: e5 License#: 310 CQ+3 Tier II : o Labeling: Spill Plan: ° os'� Oil/WaterSeparator: fJJA Floor Drains: o Emergency Numbers: `. �9 Storage AreaslTanks: VV,0Lt5 D0v 'J I t-f— P.w %w v>A ,- 5oqMSTwQ5 1w-o t llEmergency/Containment E6uipment:1*0 A5`(0AW Af, t o PtY(W� 4- Pr� IvoA,4IJ �,-t3o k Cv Waste Generator ID: Ad Ike- 5 DOD I-qJ0 0 Waste Product: -t ,rG2 � 4AST a�1' Date&Amount of Last Shipment/Frequency: LJ O ti X t wt wt<, 10V a'v%, l,1 Licensed Waste Hauler&Destination: Cvvt - l Other Waste Disposal Methods: (+Z ex erly►, V,\-k"%S 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 3ko Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 11- Hydraulic fluid (including brake fluid)�Z Windshield wash 1 NO Motor oils SoX2tvbk7115•+$'00 t r+(-L 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 NS ' ION- Refrigerants lob {bu ti0 Degreasers for en Ines& arages Pesticides: Caulk/Grout OW` -eaVTV,1JA insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries 3 o 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, J hydrochloric acid, other acids) VIOLATIONS: ` ORDERS: D 1�? e,,,4, rJ(-oV t OK INFORMATION/RECOMMENDATIONS: A&&tp Qa2, C Inspector: , Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA Bq g! 200 Main Street 9 Hyannis, MA 02601 039•0, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Business Name: S1,111VIt, 1 re, Date: S z3 /(., Location/Mailing Addres : Contact Name/Phone: a.►� 12 o.,.,rfle-ati So$ -7-T 1 -0b-T7 , M41 S08-Clog-O(t GO Inventory Total Amount: `V �100 4 4 MSDS: 16g 4, a��r� 6N- S!S License#: 311) - wk. k•c o,1 Tier II : a Labelina: V't. \a�..\ s mill Plan: 2.s Oil/WaterSeparator: N JA Floor Drains: mergency Numbers: 145 Storage Areas/Tanks: 2 S w-as#LCook kok, qV54-,---> too awk VVL.J (, Emergency/Containment Equipment: P,4 v-- -Ve, k%oo.,s, ovao- Waste Generator ID: M IBC 30°00 -7 b[3 Waste Product: 041 J�ers , ,eW4 reeFe- Date&Amount of Last Shipment/Frequency: 1 l y o0 a-I 2 nnos. ��• � .M- r Licensed Waste Hauler&Destination: M Other Waste Disposal Methods: C� �'.< av3.�.'tce �. t ka�i,Ufa t,tic o.�•.«+ .-� �S�os�1 y 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. JAntifreeze 310 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) VIOLATI NS:1r7�5 &A C Y-S i-e 5 S,D�+��t�t.c� - � lu.�, �I����, ov�C,�o•�v��, -��SC.2 E<' 0. ORDERS: INFORMATION/RECOMMENDATIONS: kk was •k+o S q 1 o o-! ka.+ (u , (.._.a\w\ yw,J L,,w5 k— o. Inspector: Facility Representative: hd A WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS INE►owti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMS�LE.D` 200 Main Street• Hyannis, MA 02601 t659. ♦0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT R.- �ED Business Name: I1Ire-- Date: Location/Mailin Address: SSA►lDx� �ay�crtn r s Contact Name/Phone: Inventory Total A ount: MSDS: c. License#: Tier ll : Labelino: G*61ook Spill Plan: Oil/WaterSeparator: Floor Drains: o Emergency Numbers: 2 5 Storage Areas/Tanks: Sol S yw '20Q, k „A, Emergency/Containment Equipment: D� 's - -� o, 5pO w45k4- o t ( Ctrle.<4 Waste Generator ID: C. 000 1q o Waste Product: Date&Amount of Last Shipment/Frequency: (o I-1 1 ir qOO,74,I / d Licensed Waste Hauler&Destination: 01 ( S V o� M wig Other Waste Disposal Methods: 'C- .� a k F tee, i tC cv- I I f mvet,n Y LIST OF TOXIC AND HAZARDOUS MATERIALS (�p Ml�-�01 L �'�2S tom- \w�w 'S�1nC��k 1k5 �sn; NOTE: Under the provisions of Ch. 111, Section 31, of the G neral Laws'bf MA, hazardous m erial use, 1 storage and disposal of 111 gallons or more requires a license from the Public Health Division. '330 Antifreeze b Sc-)v- S ' y u-``'/`-waske, Dry cleaning fluids %00 Automatic transmission fluid I-��'�`^-fi s Other cleaning solvents&spot removers Engine and radiator flushes ` Bug and tar removers Hydraulic fluid (including brake fluid) S Windshield wash f 4-k Co U(e5 sa Motor oils A�w 2�SA5'(�('��d�v�5/ °L Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants I by Miscellaneous petroleum products: k k(.�' Road salts grease, lubricants, gear oil 7p SV' Refrigerants Degreasers for engines&garages kCrk Pesticides: Caulk/Grout slat a;k�„se 1( 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: Oau-r gA Cva VW' ev oo!� Idl to I ,-- tom: O—JV Q,6 14 4, Ux1.5 Ol I L. , <-PA 4y-0,<,2 ORDERS: swl -kP. o , ,VA-Tvo<5 LJ A,- so w INFORMATION/ COMMENDATIONS: Co a S ,0- aab aa a q6A ,2 , cis Inspector: Facility Representative: V WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FIB►ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • snnMA`�,%. 200 Main Street• Hyannis, MA 02601 t639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CFO MP'�s Business Name: 51)1 hVa A---1—tCe- Date: 7 Location/Mailing Add r ss: 5S A, rpor+ t< ,, Y-irmis 0q Contact Name/Phone: 1ve- A oB--6 l-154,1-71, M-A ►r}, rog- goo-066U Inventory Total Amount: b0 qXJ MSDS: e-S License#: 31 O Tier I[ : Labelina: (Yoo Spill Plan: -e-� Oil/WaterSeparator: Floor Drains: 0 Emergency Numbers: e S Storage Areas/Tanks: al �,aabkc o,l ASTMS < P Davy.,b-'rgA•t15 o�xon ��5� Moc� ( $5- �t.�� �Q �y� Emergency/Containment Equipment: .t 1 + a S Waste Generator ID: V414 3 00 00 el tp Waste Product:0%\, mkj-50\4,5 Date&Amount of Last Shipment/Frequency: 1 9 h`� o. Licensed Waste Hauler&Destination: MO'�ZOO -7-1 Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS - Iv vv\t-5o1 Q-L�o< 5lv"L.e-\A'S NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous miterial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. -i Antifreeze so(tvk%ks v-w v.,L- Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers �— Hydraulic fluid (ii p in brake fluid) —�� Windshield wash �— Motor oils ?'IS M i)a,,�aske, 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: Dc,pDaA5 vt 05 4A-1 <.*,5 ems* -- ob��4- \AkM 1 k 1 - c�p- i d<-)*4 c /c�c�,. G��, ,SAS o, I I Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 11 l,27 / 13 TOWN OF BARNSTABLES TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: t ,« BUSINESS LOCATION: INVENTORY MAILING ADDRESS: saA,— TOTAL AMOUNT: TELEPHONE NUMBER: S48--77 t -06-77 V31 d/o-Ks CONTACT PERSON: Q&V% a ,M j,l EMERGENCY CONTACT TELEPHONE NU BER: Y08-066,0 MSDS ON SITE? TYPE OF BUSINESS: v4-o r{ a,d d.Ax M41 Ye INFORMATION / REC OMMEN ATIONS: `)L1cen5c is cucre.wEi- Pos��2 '�so�ll Fire District: A(a•�+ JVISDS host / &,o reco rpls f4 r Vart s Gl zo K&,r r{Qk c.evw-&ram }�y a$I yI 5 4) i� eco W&St2 01 calf re c11_e12 ,iJ�nt�.t Vlo� ►ti. vdy_ or 6re%,x, .o �: ans Waste Tri"0 � n: MC30000-711,0 Last shipment of hazardous waste: AV2 2a/3 Name of Hauler: Cyr, C A+A-1 Mover.5 Destination: Waste Product: wa5feo�I/s�l�cQs-Cyu .awf.Frca� Licensed a No AIA 08Z3o3"1-77 4,o5 S(" ,X-CRT r►u.+Rls� 1MYK NOTE: Under the provisions of Ch. 141, 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 Z2 p Antifreeze (for g as line or coolant systems) Miscellaneous Corrosive INEW AO ASM.r Cesspool cleaners �s. Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils �( Pesticides // -� s�' So�9`dF ''` (insecticides, herbicides, rodenticides) qg ❑yN�FW�- USED ,W14. 3�V-,-1 Photochemicals (Fixers) Gasoline, Wfuel,Aviation gas Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) to lubricants, gear oil ❑ NEW ❑ USED 2p Degreasers for engines and metal'-<Q`u10-me Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 3 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— Sullivan Tire Hyannis 55 Airport Road PAGE 1 Hyannis,MA 02601 SULLIVAN TOM (508)775-0096 AND AUTO .VICE Customer ID: 1547975 Year: DatelTime: 11/23/13 12:49:56 Name: METAL MOVERS LLC Make: METAL Workorder#: 126786 Address: BARRY N SILVERSTEIN Model: RETURN Invoice#: 89067 Address 2: P 0 BOX 2005 Lic No: 1 Key Tag: City,State,Zip/Postal Code: NORTON,MA,02766 VIN: PO Number: Home Phone: (774)444-0098 Color: Email Address: na Work Phone: ()- Engine: Fleet/Wholesale: Y Other Phone: (774)- Mileage In: 0 Unit Number: Tax Exempt#: Mileage Out: 0 Service comments: Salesperson:D. RONDEAU TIRE PRESSURE:LF NA RF NA LR NA RR NA SPARE NA TREAD DEPTH: LF NA/32 RF NA/32 LR NA/32 RR NA/32 SPARE NA/32 Qty. Part# RFR Loc Description Parts Labor Total WARRANTY EXCLUSION-To the extent permitted by state and local law,any warranty on products sold herein are those made by the manufacturer. FINAL INVOICE APPROVAL: EXCEPT FOR CONSUMER SALES,SELLER HEREBY DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FORA SHOP SUPPLIES PARTICULAR PURPOSE.Seller neither 1 ALUMWHL RECYCLED ALUMINIUM W 8.00 0.00 8.00 assumes nor authorizes any other person to 2 ALUMRAD RECYCLED ALUMINIUM RA 1.50 0.00 3.00 assume for it any liability in connection with 1 RECPAIL RECYCLED PAIL OF LEAD 18.00 0.00 18.00 the sale of said products. In states that do 1 CSTRTR RECYCLED CAST IRON 55 26.00 0.00 26.00 not allow the disclaimer of implied warranties, TOTAL SHOP SUPPLIES: 55.00 the foregoing disclaimer of such warranties will not apply to you.Limited Lifetime Warranty on Mufflers,Shocks,Struts "**Customer Wishes To Discard Old Parts*** WORK AUTHORIZATION-I HEREBY AUTHORIZE THE REPAIR WORK SHOWN ON THIS WORK ORDER TO BE DONE ALONG WITH THE NECESSARY MATERIAL(S).I hereby grant you and/or your employees permission to operate the vehicle described on streets,highways or elsewhere for the purpose of testing and/or inspection. I am hereby notified of and acknowledge that under state law you have a mechanic's lien on the above vehicle to secure the amount of repairs thereto which I have authorized and are not covered by my warranty.You will not be held responsible for loss or damage to vehicle or articles left in vehicle in case of fire,theft,accident or any other cause beyond your reasonable control. Notice:Wheel Torque Validation Wheel fastener torque must be checked within the first 50 miles following this service PAY AMOUNT PARTS TOTAL 55.00 For house charge accounts, HOUSE 55.00 SALES TAX 0.00 Please remit all payments: LABOR TOTAL 0.00 Sullivan Tire Co. Inc. TECH: GRAND TOTAL 55.00 Attn:Credit Department PO BOX 370 Rockland,MA 02370 Now featuring Gift Cards! THIS IS A HISTORY REPRINT (Reprinted: 11/27/13 11:46:18) Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis, MA Is.Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. V� IS', - - - - -------------------- --- -------------------------------- --------- : - This license is granted in conformity with the Statutes and ordinances relating there to,and NIS and expires 06/30/2018 unless sooner suspended or revoked. ------------------------ ------ -------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health i f - Unstableerv iRoewg%atoces p� Richard V. Scah,Director /. A Public Health Division BARNSTABLE w • g 'W,,IOIf•,Fxi[RVILLE•COIUR•NTu1:15 `C s ssBLE. Thomas McKean, Director vRS,USe,_516 39'21 aelsre> s*<et derv 200 Main Street, Hyannis, MA 02601 �'Dg -a018 Office: 508-862-4644 Fax: 508-790-6304 - -q APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNSrJULY-1 stt==JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 X VS- *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO.V 2. IS THIS A PERMIT RENEWAL? . YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:SGok� MA z- flE✓ 5. NAME OF ESTABLISHMENT: S A z VG N 'Yl 6. ADDRESS OF ESTABLISHMENT: Qf-5 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ACLbAj 40,AA,k 'b�IVIQ AJ-brW b( h1� 3. TELEPHONE NUMBER OF ESTABLISHMENT46 _-7 7,G 0OF-L 9. EMAIL ADDRESS: 5�, -• Rr 11) SLl-kk -�VA0 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME &,[� Vwt,) 1:- 4 t_ PRESIDENT R'O)&,A V C tA•W U•t J TREASURER S>y Z A cci\ao CLERK L a&pi S A e.0 srk 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT Q: DATE �Application Forms\HAZMAT APP 2017 RE SED.doc °-zo p1r,0 - (eWX-�\ Le A-J Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $150.00 - Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and - and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I i y TOwn of Barnstable Regulatory Services p. Richard V. Scali,Director . :$ C �► Public Health Division $ ST $LE o M�+ Thomas McKean Director , . 05 200:Main Street,Hyannis;M-A 02601 " Office::,508-862-4644 Q Fax: 508-790-6304 .A APP ICATION FOR PERMIT TO STORE AND/OR UTILIZE w HAZARDOUS MATERIALS 'IN ACCORDA E.WITH THETOWN'OF BARNSTABLE•GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS TER7ALS,ALLBUSINESSES THAT HANDLE OR STOKE HAZARDOUS MATERIALS GRFATERTHANHOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL*PE .(RUNS JULY Ist-.JUNE 3Oth). APPLICATION FEE. S CATEGORY 1`PERNHT 26- 110 Gallons: $ SO.UO . .CA GORY 2 PERMIT `111 —.499 Gallons: $12$.00. Q CA GORY 3 PERMIT 500 or.more Galloxis: 150 ( l YES' - 1. 0.00wassessedif of received. b_ l._.1_.s_t..A ate char a of il b Ju �r. ASSESSORS` AND PAROEL'NO. „ DATE_ Z.tbl. ,.M. L NAME C F APPLICANTS NAME OF EST kBLISMAENT. S tvAo A_�. ADDRESS OF. STABLISHMENT: SS h k �3 oftT �L1G: _ MAILING AD RESS(IF DIFFERENT)A NeCp rd, PAT vti hja�Qcjj MA_ o)-o 4 1 TELEPHONE TMER OF ESTABLISHMENT: I -775 —odlq It n :ADD ss:_S � e,fk-z os Cal LkW� v g a cne C.e w\ SOLE OWNER YES NO IF NO,NAME OF PARTNER: FULL NAME,, OM ADDRESS,AND.TELEPHONE#OF: CORPORATION NAME. Lk l v Ao T%4.4 Isso ' PRESIDENT Cho , . . TREASURER CLERK V , IF PREPARED BY OUTSIDE PARTY: • SI AT PLICANT _ Name: Company Address Tlehone#: Email: Q:1Applicat�oq ormsl. PReY1:6doox . Page102 . v '.� m,� wV'I i ia;:r`. ,k�..n T �Y v a.n iemr • f h — yy .f�A t .. .. { i..t �. `� F 3 I Z�1 f f a � ' � 1 f t d� G. 1 . ....� .. _.. ..... � .-.. .. - k. fir,<`r. f �� Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis, MA 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health AUG-5-2015 04, OA FROM: T0:17818710176 P.1/2 76 Town of Barnstable Regulatory Services Richard V.Scali,Director ? SAMMBUL ` Public Health Division Sol .'ram► ' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. ` �b 0/ DATE r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERTALS FULL NAME OF APPLICANT `,O 1 V VMb 1) �C—) NAME OF ESTABLISHMENT 30 �(NLln ADDRESS OF ESTABLISHMENT 2j5 O-A TELEPHONE NUMBER '�" 1 � 00 . SOLE OWNER: YES s NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER I CLERK S RE OF APPLICANT • RESTRICTIONS: HOME ADDRESS 1...�1 M -04 Q Nr W�.�Dl��� HOME TELEPHONE# I -Cf a-1.5d JAUMAPPDDOC r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 • * ,A Public Health Division yMASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt 'Hazardous Materials Payment received: $100.00 (Check) on 8/10/2015 Permit number: 310 Check number: 259402 Check amount: $100.00 Name on check: Sullivan Tire Business: Sullivan Tire Company, Inc. iAddress: 55 AIRPORT ROAD, Hyannis I • 0 I ` f i i Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis, MA 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 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health �I. JUN-277` , x , , w 3 .> Regt atpry- "Pr,"Ces ardxV.'Sea, l hector Publ tc H alf tDivIsIon Mla •_ r 00 main street,.Ayamn* ,MA 0264 e Appiictian� t3OOi " 0 July 1, 2 014 A" gAS_*&?, PARCELNO.'294 / 016/ 0 pATE _ a +4iit'i Ti i S�il�tl xA �l 1 JA[J�+lii`t L��/ tJ 'Iz MORE 1> A t, » c 4111,9A L�fJt�s? � 11F7"lrltk�'11R S, Sullivan Tire Company "Sullivan Tire and Auto Service E` Airport Road, Hyannis, Massachusetts 02601 ADDRESS d1+EST`ABLISH1Yi1T *i D ER. SOLEOWNEPU _ T�,�j.,l�• .,�s_�e��r�+kr��,�,., �(1c .tom-141� °^ y� y�,�p �,€T x1ri�,y�0,. �t�} +�, IF AM t J6 JIX7;A Jc. '11 RAAO4_ dLlir�:t'1�t1•A.F+.�At� .t9«�DREV A OI AU' ... io s. r w ^. q . l�'i�pI.,ICANT LS�CQRPORATIUI+t,.'�'ED�tAL IDS_ CA�(?�t NO.- . STATE QF CORI'+ RATIO N �tj S I+�UI.LIYA A1D <dv44�1u.`ADD �s QI�.,, x TRSITREI �, i• b s ri:` t �a ra r L} t>o ST L Cr z SIGIVA APPLICANT, t REi l&i6NS r HOM,ADD ss: �0_1 Q:lApplIcallay Potms AT�APP I7OC, y Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, 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 1� r n Town. of Bams-ta-ble ' Regulatory Services Thy McKean,Dhwtar 2100 Mdn S Ham,MA 02601 Ofcn: 508-S62-4644 F= 5U&790-6304 Appiiaabon Fee:$10fl,D0 AssE:ssaRsP Axa PABCO .PZO. ��U t o t9 APPLICATION FOR PERhM.TO STORE A-WOR UTILM THAT ill GALLONS OF HAZARDOUS RDOUS MA=A—LS Y=NAIM, OF APPLICANT z O tLA_AE OF ESTABLL%g '''VT ADDRESS OF ESQ�R-T7�MtT Ni T (� O vi < 'CIO 5'( - ��� TE�.PH01YE N'DN� �, SOLE Off:VYES PTO r OF A PLIC .NT B A PriRTMR5'SJP,FULL MAW AND.HOB ADDRESS OF ALL IF APPLICANT IS A CORP0RAMON. FMMAL ID-K=CATSON NO. STATE OFETCORPORATIOPt ASS FD,D NAIWE AND HOM ADDRESS OF: Mul IyCAh Cog • F�.P I RESMCTIONS: HOPE ADDRESS M� HoBa TEIMHO,E# Nam dnctwp/q Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, Hyannis,MA 02601 p 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 6/30/2013 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 s Number Fee 160 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Jack Ellis Foreign Auto -T SI S West Main St., Hyannis,MA 02601 — Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ _G ------------------------------------------------------------------------------------------------------------- ---------------------------------------------------- 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 if Town of Barnstable 0F1 Regulatory Services Thomas F. Geiler,Director '" MASS. E ' Public Health Division °Tina 39. )A Thomas'McKean,Director 200 Main-Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT (TA t k LG`S Q r--e I 0� �u A 1AP ` ADDRESS OF ESTABLISHMENT �1✓� Kl e 57 /rl —/ TELEPHONE NUMBER SOLE OWNER: y S NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL,-' I PARTNERS: F IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK r SIGNATURE OF APPLICANT � I n i �d .lib t'5 ��1���f �► � RESTRICTIONS: HOME AD ss 9 80 old ��./M J _ e o HONE TELEPHONE �1;"/� � — Haz.doc/wp/q iri I , Emergency Coorftator,Names _ Addr=ss: r tr Me Daytime Phones F g— 7Z �LL� Evening Phone: -T- UAT— 17:off --- �j`r e O� Fire I)cpa ens: „' �7rJS-� _ 3 �' off' Barnstable Public Health Division: 5€ 9-8f2-4w DEP 24 Hour Spill Hot Line: 98`8-3 1133 Waste Mauler: Name: 0- A/ Phone: -- -� Building diagram indicating lawdous matcrial/waste storage area,location of absorbent scavenger materials,fire er ngu stem, fire alarms(if present), and evacuation route(if applicable). Fr D A-It ' .. 1r,51 $ OpFte� d r � 5 i+ a F,r.� ,1.a r�+3 trek Amp% Lao AIsms WAY 5 ;I oV-er #OAJ QL#h& .e POOrS tit ➢doh^ &FFrc,e Actions to be taken toD*nt of a�or release,and preventing it from- reaching a catchIba/sin, sewer system or the ground. Yoe :-!I l! /-1 7 -ram 3 b 4f 1 Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. �— 55 Airport Road, 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 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health d Town of Barnstable THE�� Regulatory Services Thomas F. Geiler,Director '"R'".ST"BMAM'� ' Public Health Division 0 Ar ib39 A e + Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Su f \0 n I ae2 NAME OF ESTABLISHMENT 1 a W ADDRESS OF ESTABLISHMENT 55� Al r- . r+—C6cA M 4- TELEPHONE NUMBER SOLE OWNER: YES_)� NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: t.v ' c M IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ('� 1 -j\ STATE OF INCORPORATION I�S FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK l (-Loe- \ 'fjC) SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q Town of Barnstable _ Barnstable �oFIKKEraw Regulatory Services Department ZftmicaCft BARNSFABLE, Public Health Division 9pp i6 SS. 200 Main Street, Hyannis MA 02601 2007 1 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 M.4 ? � �L d ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ., &pe- f), P- NAME OF ESTABLISHMENT F lt-) 1 /►ry C /l N P4?/ rIPC ADDRESS OF ESTABLISHMENT l/ / k ,� �/� 4 TELEPHONE NUMBER S© � 72 91 SOLE OWNER: /YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0�-3 � STATE OF INCORPORATIONd , �I FULL NAME AND 0 O E ADDRESS OF- PRESIDENT A tF L4 6) fi- ill TREASURER CLERK I F APPL CA 7/- RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# �j ,0 1.? Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 310 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. 55 Airport Road, 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 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF;D.M.D. 6/30/2010 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health 1 v J ' Town of Barnstable of1HE Tp� Regulatory Services � ti ° Thomas F. Geiler, Director BA LE.MASS. a•`' Public Health Division MASS. 1639- O m �pTFDMA�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT _�LL't Vi4� l Cc► ,, ��-C_ ADDRESS OF ESTABLISHMENT A - 20 �,urs off! TELEPHONE NUMBER SOLE OWNER: YE�A�NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION ()34 FULL NAME An HOME ADDRESS OF: , PRESIDENT f�G6 z7- TREASURER ��� vim. `-��w►� ��Qj gZ,Q, . CLERK • SIGxRrURE OF APPLICANT RESTRICTIONS: U-QME ADDRESS 6 J. -URME TELEPHONE # oC�Zp Flaz.docA%p'y e. • MAIL-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in-house processing. 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 arnouiTthk*" ',6feez at bottom of this page). Please make the check payable to: DIN Town of Barnstable. The check mot be,'11 led to the address listed above. Allow up to four days for in-house processing. t ,F For further assistance on any item above, call (508) 862-4644 _ I Back to Main Public Health Division Page • • f N s • • Sullivan Tire Company Hyannis, MA #44 Emergency Response Plan (post (q)- #44 w/MSDS Book) Mission Statement: Sullivan Tire is committed to providing a safe working place for employees, customers, invited guests and contractors. This guide will provide information to assist the user in responding to various emergencies at the facility. Notification Pirocess: Police: Telephone - Direct Dial 911 Fire: Telephone - Direct Dial 911 Ambulance: Telephone - Direct Dial 911 Local Hospital: Telephone — 508 771-1800 27 Park Street Hyannis, MA 02601 Town of Barnstable Public Health Telephone— 508 862-4644 Driving Directions With Map on Next Pane S��'d 989H80b8aS� 01 :WOdd dii:ia OT02-9i-Nnf Live Search Maps Page I of 2 Print[his page in a more readable format:Click Print next to the upper-right corner of the map. Driving directions:'55 Airport Rd, Hyannis to 27 Park St, Hyannis Aaxi M A. S S A C H U! S--'- E 0,01,00% k DM ; 13 A N S 1 A B L E b Cap$Cod or Mail prii.ptabie.Muncipa Al, CA J. Qj g t? 2 V ALf C3 . 0 f- -il I . k. r N � It,"- tii, f Aruca st, J % C'� CJ > 4 Hyah n1s, kl*Fta YOY k ti t -'s S Vq I A Start: 55 Airport Rd, Hyannis, MA 02601-1801 A-B: 2.2 mi, 6 min 1. Depart Airport Rd 0.1 mi 2. Turn left onto SR-132 I lyannough Rd 0.7 mi DAYS INN on the comer 3. At roundabout, take 3rd exit 0.9 mi 4. Turn right onto Cedar St 0.2 mi Turn left onto Main St, and then immediately turn right onto Parkway 0.2 mi 5. PI 6. Turn right onto Bayview St 0.1 mi 7. Turn right onto Park St 0.1 mi 8. Arrive at 27 Park St The last intersect,on s Bayview St If you reach Gleason St,you've gone too for B End: 27 Park St, Hyannis, MA 02601-5230 These directions are subject to the Microsoft®Live Search Terms of Use and for informational purposes only.No guarantee is made regarding their completeness or accuracy.Construction projects,traffic,or other events may cause actual conditions to http://maps.live.com/default.aspx?wip=2&v=2&rtp=—&FORM=MSNH 4/3/2009 S/2*d 989O8Ot780S T:01 :WOdJ dTT:TO 0To2-9T-Nnf Hazardous Material Spills/Fumes: Refer to the information contained in the section herein titled Hazardous Material Spills/Fumes Report spill immediately to: Ken Hogan @ STC.....................................800 892-1955 if unavailable call..................... Wayne Funder @ STC ................................800 892-1955 Dan Sawiski @ STC ...................................800 892-1955 Media Contact: Paul Sullivan.........................600 892-1955 (do not discuss or offer opinions etc., to anyone) General Emergency Notifications: • Determine if a life-threatening event has occurred • Evacuate the area • Activate fire pull station or call the fire department— report your name, address, telephone number and type of emergency. Do not hang up until the person acknowledges your message • Maintain your composure and follow this plan • Do not use elevators or other similar devices Block Plan Exhibit w/HazMat storage (inside cover for review) Fire Fire is a serious hazard and Sullivan Tire requires employees to call their local fire departments to attend to facility re fires. As required, Sullivan Tire has fire extinguishers that can be used if the q 9 fire is not too large or perceived as being beyond their capability. Facilities have permanently mounted extinguishers located throughout the buildings near hazards and exits. Confirm the location of extinguishers at your facility in advance. Fire Types. • Class A fires - Paper, wood, cloth (#) of H2O • Class B fires - Grease, oil, gasoline (SF) Dry Chem CO2 • Class C fires - Electric (Halon, FM200) C = non conductive agent • Class D fires - Metal — Dry Powder • Class K fires - Kitchen (grease, fat, oil) -Alkaline mix • Our extinguishers may appear different in size, shape or color. However, they are all rated to handle the types of fires that could happen in our facilities e.g., A, B and C. Fire Extinguisher Operation: Pull the handle pin at the top = P • • Aim the nozzle 8 feet away from the base of the fire = A • Squeeze the handle to begin discharge of the contents of the extinguisher = S • Sweep the nozzle back and,forth at the base of the fire = S S/Z'd 989080b80SZ:01 :WOdJ d2T:ZO 0T02-9i-Nnf f - - Remember- the word PASS to assist you in extinguisher operation 1 Workplace Fire Hazards (inspect daily): Smoking areas: outside and 50' min from structures in designated areas with approved smoking receptacle ; Buffer dust collection system; Heating, ventilating, and air conditioning systems, including their pipes, switches, wiring, and boiler controls; Electrical equipment, including wiring, controls and extension cords; Forklift service areas; Flammable liquid and gas storage; Hot work areas (retread curing chambers); Storage areas - packaging, including tread rubber and supplies; Waste removal; 1, Rag storage— approved metal closed lid containers only; ' Exit paths clear; Emergency Shut Offs— clear access e.g., sprinkler valves, electric panels, various equipment shut down controls Evacuation/Assembly Route Leave the building from the closest marked exit (see attached block plan) and assemble at the predetermined assembly area for your site which must not interfere with emergency vehicles. Render assistance to all physically challenged people. Site Safety Representative or manager, in his absence, will coordinate the evacuation and as such will ensure that everyone has left the building. A headcount will be taken and compared to available sign in information to ensure that all employees, customers, invited guests and contractors have been accounted for. First—Aid Kit Location The first aid kits are located at Ensure that they are stocked with dated supplies. Do not attempt to perform any first aid that you are not trained to do. Illness or Iniury Follow the above listed notification process. Do not move or leave the person unattended. S/b'd 989080b80SI:01 :WOaJ d2I:Z0 0Z02-9Z-Nnf Cuts,Wounds and Blood —wear surgical gloves apply pressure with clean cloths. Elevate limb above the level of the heart. Burns form Heat & Chemicals— rinse the affected area with cool, clean running water for 5 minutes Bomb Threats Follow the above listed notification process. Note time of call, caller's age, gender, vocal characteristics etc. Ask questions such as: • what kind of bomb • where is it located • when will it detonate • caller's name • caller's phone number • caller's location Acts of Violence/Other Disturbances: • Follow notice procedure listed above • Demand that the acts be stopped • Do not become physically involved 1 Hazardous Material Soills/Fumes: • If an "unscheduled release of material has occurred" do the following............................. Attempt to verify the source of spill or fumes • Refer to your MSDS (Material Safety Data Sheet) book and NFPA 704M labels in order to better evaluate the hazard level and PPE needed • Utilize spill kit supplemented with disposable absorbent pads and materials on hand • Contain the spill or fume source • Stop or dyke the discharge • Block paths to drains, the environment, and nearby water sources including wetlands • Do not activate any sources of ignition including electrical switches • Close doors and vacate the building • Only after it has been determined by the above STC people that a further approved clean up response is required (typically spills of hazardous materials greater than 10 gallons) call Clean Harbors Environmental Services, Inc. @ 800 645-8265 and the Town of Barnstable Public Health Division @ 608 862-4644 Natural Disasters (Flood, Hurricane & Earthquake): • Notify HQ • Listen to public communication media • Relocate computer equipment • Protect glass by boarding or taping • Relocate people to safe areas S/S'd 989080b80Si:01 :WOaJ d2T:TO OT02-9I-Nnf N L= 120 W=50' m W o 3 3' X 5'CLEAN 3'X 6'WASTE OIL TANK OIL TANK Bay - 9'X 10, CONTAINMENT PALLET WITH 55 GAL DRUMS (NEW AND WASTE i OFFICE COOLANT)SPENT OIL 12'X 7" FILTERS qR I i SHOWROOM 4'X 10' I ind RR 25' X 20' GENERAL AUTO i CHEMICALS --------------- Bays--—------------------ o cn m Q7 A m co co _ SULLIVAN TIRE CO., INC#44 55 AIRPORT ROAD HYANNIS, MA �V Rockland Crust gprr' 4i y 1 824� FAMILYEAR CARE CENTERS Sulhvarr Tire.'Co Iiir s3 44� 41 Accord Park brive 113 6/24/2010 182459 $********100 .00 Norwell, MA 02061-.:1.614 Dollars One T0 THE ORDER TOWN,.:OF BARNSTABLE of 2 0 0 MAIN ::ST HYANNIS MA 02601 Ila 18 2459110 1:0 1 1304L, 781: 2 le,0491-1 17 III" Number Fee 310 THE COMMONWEALTH. OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Sullivan Tire Company, Inc. SS Airport Road, 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 6/30/2010 unless sooner suspended or revoked. ------------------------------- ------ WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health i Town of Barnstable Barnstable IME Taws Regulatory Services Department AD-ft eriea C" • IIARMSTABLE, Public Health Division O D ' moo IM ASS39. 200 Main Street, Hyannis MA 0260 16 ArfO MA'S A, l 10 a v v 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �'�' 4-1 LZ-" �fA--) NAME OF ESTABLISHMENT �L L t V A ./ 7 12e Co . &'C. ADDRESS OF ESTABLISHMENT 'J �' ��-' 0 A<— TELEPHONE NUMBER r 4 SOLE OWNER: ✓YES NO c k v co IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OIF ALL PARTNERS: Z3j IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION /'Y) FULL NAME AN HOME ADDRESS OF: PRESIDENT 0!3E ram" S v L.4-+v aka/ TREASURER U�- 3 " L i .c �J'A 0 �1 CLERK -- IGNATURE OF APPLI • RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC , f • MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc.) In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow time for in-house processing. 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. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition, please mail the required fee of$100. Please make the check payable to: Town • of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page • Q:\Hazmat\Haz Mat Application2008.DOC 4 L= 120 ' W=50' 3' X 5' CLEAN 3' X 6'WASTE OIL TANK OIL TANK Bay 9' X 10' CONTAINMENT PALLET WITH 55 GAL DRUMS (NEW AND WASTE OFFICE COOLANT) SPENT OIL 12'X 7" FILTERS 4' X 10' SHOWROOM GENERAL AUTO ind RR 25' X CHEMICALS ---------------- Bays------------------------ . � SULLIVAN TIRE CO., INC #44 55 AIRPORT ROAD HYANNIS, MA r t 1 • Sullivan Tire Company Hyannis, MA #44 Emergency Response Plan (post (aD #44 w/MSDS Book) Mission Statement: Sullivan Tire is committed to providing a safe working place for employees, customers, invited guests and contractors. This guide will provide information to assist the user in responding to various emergencies at the facility. Notification Process: Police: Telephone - Direct Dial 911 Fire: Telephone - Direct Dial 911 Ambulance: Telephone - Direct Dial 911 Local Hospital: Telephone — 508 771-1800 27 Park Street Hyannis, MA 02601 Town of Barnstable Public Health Telephone — 508 862-4644 Driving Directions With Map on Next Page r Live Search Maps Page 1 of 2 r Print this page in a more readable format:Click Print next to the upper-right corner of the map. • Driving directions:•55 Airport Rd, Hyannis to 27 Park St, Hyannis 0.f u M d� g, $ A E t T'' v Auk am'.Rp" g. A !�@ S ryT A-� B L I132r R E'. 0. C;od „rsrebr � 5. F Mall `ice g BamStalbl Wirtldpffll,Alirporr rr N iy Ul J • r , E y k r b ! t" .' -92 ri ' cam, 4PO CO c Q y �1 't ySfrHyan fs I m a' t F,J. K. m • A Start: 55 Airport Rd Hyannis, MA:. 2 1-1 ,1 po0 60 80 A-B: 2.2 mi, 6 min 1 . Depart Airport Rd- 0.1 mi 2. Turn left onto SR-132 I lyannough Rd 0.7 mi DAYS INN on the comer 3. At roundabout, take 3rd exit 0.9 mi 4. Turn right onto Cedar St 0.2 mi Turn left onto Main St, and then immediately turn right onto Parkway 0.2 mi 5. PI 6. Turn right onto Bayview St 0.1 mi 7. Turn right onto Park St 0.1 mi 8. Arrive at 27 Park St The last intersect!on s Bayview St If you reach Gleason St,you've gone too far r • B End: 27 Park St; Hyannis, MA 02601-5230 These directions are subject to the Microsoft®Live Search Terms of Use and for informational purposes only. No guarantee is made regarding their completeness or accuracy. Construction projects,traffic, or other events may cause actual conditions to http://maps.live.com/default.aspx?wip=2&v=2&rtp=—&FORM=MSNH 4/3/2009 r r � . f Hazardous Material Spills/Fumes: Refer to the information contained in the section herein titled Hazardous Material Spills/Fumes • Report spill immediately to: Ken Hogan @ STC...... ... ............................800 892-1955 if unavailable call..................... Wayne Funder @ STC ...................... ...........800 892-1955 Dan.Sawiski @ STC ... ............... ......... .........800 892-1955 Media Contact: Paul Sullivan............ ...... ... ....800 892-1955 (do not discuss or offer opinions etc., to anyone) General Emergency Notifications: • Determine if a life-threatening event has occurred • Evacuate the area • Activate fire pull station or call the fire department— report your name, address, telephone number and type of emergency. Do not hang up un%the person acknowledges your message • Maintain your composure and follow this plan • Do not use elevators or other similar devices Block Plan Exhibit w/HazMat storage (Inside cover for review) • Fire Fire is a serious hazard and Sullivan Tire requires employees to call their local fire departments to attend to facility fires. As required, Sullivan Tire has fire extinguishers that can be used if the fire is not too large or perceived as being beyond their capability. Facilities have permanently mounted extinguishers located throughout the buildings near hazards and exits. Confirm the location of extinguishers at your facility in advance. Fire Types: • Class A fires - Paper, wood, cloth (#) of H2O • Class B fires - Grease, oil, gasoline (SF) Dry Chem CO2 • Class C fires - Electric (Halon, FM200) C = non conductive agent • Class D fires - Metal — Dry Powder • Class K fires - Kitchen (grease, fat, oil) - Alkaline mix • Our extinguishers may appear different in size, shape or color. However, they are all rated to handle the types of fires that could happen in our facilities e.g., A, B and C. Fire Extinguisher Operation: • • Pull the handle pin at the top =:P •4 Aim the nozzle 8 feet away from the base of the fire A- • Squeeze the handle-to begin discharge of the contents of the extinguisher = S •� Sweep the-nozzle back and forth at the-base--of the fire = S f t Remember - the word PASS to assist you in extinguisher operation Workplace Fire Hazards (inspect daily): • Smoking areas: outside and 50' min from structures in designated areas with approved smoking receptacle ; Buffer dust collection system; j Heating, ventilating, and air conditioning systems, including their pipes, switches, wiring, and boiler controls; Electrical equipment, including wiring, controls and extension cords; Forklift service areas; Flammable liquid and gas storage; Hot work areas (retreadcuring chambers); Storage areas - packaging, including tread rubber and supplies; Waste removal; Ragstorage — approved metal closed lid containers only; 9 pp • Exit paths clear; Emergency Shut Offs — clear access e:g., sprinkler valves; electric panels, various equipment shut down controls Evacuation/Assembly Route Leave the building from the closest marked exit (see attached block plan) and assemble at the predetermined assembly area for your site which must not interfere with emergency vehicles. Render assistance to all physically challenged people. Site Safety Representative or manager, in his absence, will coordinate the evacuation and as such will ensure that everyone has left the building. A headcount will be taken and compared to available sign in information to ensure that all employees, customers, invited guests and contractors have been accounted for. First— Aid Kit Location The first aid kits are located at . Ensure that they are stocked with dated supplies. Do not attempt to perform any first aid that you are not trained to do. . Illness or-Injury Follow the above listed notification process. Do not move or leave the person unattended. r tCuts, Wounds and Blood — wear surgical gloves apply pressure with clean cloths. Elevate limb above the level of the heart. Burns form Heat & Chemicals — rinse the affected area with cool, clean running water for 5 • minutes Bomb Threats Follow the above listed notification process. Note time of call, caller's age, gender, vocal characteristics etc. Ask questions such as: • what kind of bomb where is it located when will it detonate caller's name • caller's phone number • caller's location Acts of Violence/Other Disturbances: • Follow notice procedure listed above • Demand that the acts be stopped • Do not become physically involved • Hazardous Material Spills/Fumes: • If an "unscheduled release of material h "as occurred do the following... ... ....................... • Attempt to verify the source of spill or fumes • Refer to your MSDS (Material Safety Data Sheet) book and NFPA 704M labels in order to better evaluate the hazard level and PPE needed • Utilize spill kit supplemented with disposable absorbent pads and materials on hand • Contain the spill or fume source • Stop or dyke the discharge • Block paths to drains, the environment, and nearbywater sources including wetlands 9 • Do not activate any sources of ignition including electrical switches • Close doors and vacate the building • Only after it has been determined by the above STC people that a further approved clean up response is required (typically spills of hazardous materials greater than 10 gallons) call Clean Harbors Environmental Services, Inc. @ 800 645-8265 and the Town of Barnstable Public Health Division @ 508 862-4644- Natural Disasters (Flood, Hurricane & Earthquake): • Notify HQ rA • Listen to public communication media • Relocate computer equipment • Protect glass by boarding or taping •r Relocate people to safe areas kwh\w\m d\st:e rp2009O4O2#44 I I L Town of Barnstable . d Barnstable �oFj"E TOwti Regulatory Services Department AFAmenCaCtfy • Public Health Division nARNseA©LE, 9� 39- � 200 Main Street, Hyannis MA 02601 m Arfb MAt A, 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE in7TTl•,Wynn nnd-% Vnnn"jr A 1►TTL/11T) TTTTT T7T'i 165008 li Invoice Number Comments Invoice Date Invoice Amount Discount Net Check Amt waste Oil fee WASTE OIL FEE 2009 3/1/2009 100.00 0.00 100.00 a LIME= SUMOVAN QQ` Rocicl'and Trust Company 6 50 0 V.. FAMILY CAR CARE CENTERS' Tire....Co Ixlc;; 53 447' 41`Accord Park`Drtve` Its Norwell;..MA0206I 1:6.L4 478/2009 165008, **100.00 Ax., One Hundred and 00/100. - -7.7 - --7 T. Dollars;.` O TI RD TOWN OF:..BARNSTABLE Qr TAX COLLECTOR Do BOX":.1360;TC H:XANNIS, MA 0260,i ;.. ii' 16 S00811' 1:0 1 L 3044 781: 2111049 1 7 lei' TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS:_i�w� y` tr Board of Health MAILING ADDRESS: ul''S' o�r-T ��� . T �5. Town of Barnstable TELEPHONE NUMBER: '�tj? a P.O. Box 534 CONTACT PERSON: `�P �,F,� � 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 anytime, 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 t. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) l/ Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants iesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, C/ 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 � lge Swimming pool chlorine Car wash detergents f 4 Lye or caustic soda l � Car waxes and p Y olishes/ Jewelry cleaners Asphalt & roofing tar Leather dyes U LI 4 PI AI+- Paints, v s, starrrs;des 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 4 J s TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 0 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY °� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS &ff lass. 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALSCase 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) un,,� transmission/hydraulic Synthetic Organics: degreasers hy4wo 94111i A 02.10 Miscella ous: DIS OSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2.W ter Supply 0 Town Sewer ublic ,V On-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES-NO ORDERS: 0 Holding tank:MDC (1M eZ4e`yr . �f Catch basin/Dry well (b On-site system ell 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. 4 aZ4� L-Ipe-rson- (s) nterviewed �Inspector D e l ' O W N. O F BAR N STA B L E T •2. Printers s O satisfactory a 3. . Auto Body Shops aOA, O HEALTH (unsatisfactory- 4. Manufacturers -' (see"Orders") S. Retail Stores COMPAN -�; 6. Fuel Suppliers Class: 7. Miscellaneous ADDRESS - - � QUAN7' TIES AND STORAGE (IN indoors; OUT=outdoor, c� 1_ Q Nio� Case lots Drums AbdveTanks Undetground Tanks MAJOR MATERIALS IN UT O I A z e s Fuels: ' Gasoline, Jet Fuel (A) +Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: . degreasers ell, t� U � Miscellaneous: f DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply OTown Sewer 0,Wblic !� On-site Q Private .3. Indoor Floor Drains: YES NO -- -.- O Holding tank: MDC + OCatch basin/Dry well ._�..�_._._..._. ______...-..._• -- --- - 0 On-site system 4. Outdoor Surface drains:YES NC ' Q Holding tank: MDC OCatch basin/Dry well — ----- ----- OOn-site system S. Waste Transporter Licensed? ' ! 13atnHauler_ D et;na i o 2 .23 el Person s) AIM.-irviewe *" Inspector Date HHNS i r LE NFL; Puic — - - GPARd OF I-ILAIJI-I ,o4satisractory .• 2. Printers 3. nnuto . t'od Sltops ;,I (unsatisfactory- 4. ' Ilanufact�rers COf1PANY l Q C (see"Orders,, 5. Retafl, Stores AUURCSS (�,U ��i' L - r� 6. Fuel Suppliers `` � ° Classt 7. Mist; llanenus QUANTITIES AND SIORAGD (IN-indoors; OUT-outdoc ,MAJOR b1A7.rswtS Case lots Drums AboveTanks Underground Tatiks l:ue)ss . LUL �d_ our _A a tte]lon� g Gasoll;;e, jet fuel (A) Diesel, Kerosene, 12 (d) — Ileav; Uilst waste motor oil C / ) — r new motor oll transmission/hydraulic ' ) � ' Synthetic Organics t •� t 'liscellaneouss _ . Sanitary Sewage Z. Water SupplyFU'nKSt QTown Sewer ,Public GG' ru v On-rite ! t/ Q Private Indoor Floor Drains: YCS NO Q holding tanks, MUC z. f Qrq r �, t ch basin/Dry well ff,� �'-� QUn-site system ------- Outdoor,Surface drains s 1"CS NO Q Iluldln`• tanks Q Catch t basln/Ury well ' Q On-site Ystem s -----Y--� _� r�• , Waste Transporter -. l4a�me of Ha�gr ,����_lnn ; l,1ce►tsedT 1 11(nste prod �r _YES ti'� arson s` " nt.ery • nRpectat -�.�