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0192 AIRPORT ROAD - HAZMAT
�nG� 0295= v� `� Oo� - . - _ �1�1 �z m�� _ i ���� i I i ,- s� '9Jr-6 jr? ,-00 'Number Fee 1148 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CAPE COD WINWA TER CO. 192 AIRPORT ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons 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 , k Director of Public Health 1 i Town of Barnstable Inspectional Services BABSTABLE jr 14 CY THE�pL" u'P�;c'u n`:Kvu;���•'.iO�'ii Public Health Division .639 • ��5� I s • BAxMASS. Thomas McKean, Director MASS. 're1639. 06. 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-63 4 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, j HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER-THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUN JULY I st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26 — 110 Gallons: $ 50.00 El CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 [ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *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? V'IYES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGIBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGMSE OF GREATER TI11AN HOUSEHOLD £QUANTITIES (25 GALLONS)? YES NO. • 4. FULL NAME OF APPLICANT: C..v i r 5. NAME OF ESTABLISHMENT: C_p_p_P_ Co d (-0 I 6. ADDRESS OF ESTABLISHMENT: q2 14-trI064 7Z 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 5 9. EMAIL ADDRESS: C 05aoLa O c utaL,J 4<rLA.)o ,-k s o `otV\_ 10. SOLEOWNER: YES VN'0 IF NO,NAME OF PARTNER: 7'c 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME co a (1� PRESIDENT C &t A i r-- TREASURER k CLERK X 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 11 21 Q:�Applieation Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1148 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CAPE COD WINWATER CO. 192 AIRPORT ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons 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 ry r a TowA of Barnstable eg atory eivices aQ Tx�r Richard V. Scali,Director Public Health Division BAMSTABLE i �' BINt SI➢IE.QMG0.'AYP.COIYR•M rc i'm" BARNGI•ASL&, 1 xxasiatR euus.�texvwx•wm6ramumc Thomas McKean,Director 1679-2014 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax; 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZEk HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, E HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 3 0th). APPLICATION FEES P� +41 O L 44 CATEGORY 1 PERMIT 26-110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111-499 Gallons: $125.00 A— t�. � CATEGORY 3 PERMIT 500 or more Gallons: $150.00 C-/1 K� 41:. *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/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. • 4. FULL NAME OF APPLICANT: Ca i a 5. NAME OF ESTABLISHMENT: CC,ro p (-n A (,0 i�, �,��- 6. ADDRESS OF ESTABLISHMENT: (-I Z iq Moor+ 2 el kQcj im is �Ag d�� o j 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8., TELEPHONE NUMBER OF ESTABLISHMENT: 509'-Ao Z ©I(Q (0 9. EMAIL ADDRESS 10. SOLEOWNER: YES ✓O IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT ' TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 1 20. �.— Q:\Applickon ForrnsIHAZMAT APP 2017 REVISED.doc Number Fee 1212 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Homzans Associates LLC 192 Airport Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons 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. ---------------------------------------- �9' WAYNE MILLER,M.D.,CHAIRMAN 0 PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health ' S C r` r P 1 Town of Barnstable • �tti Regulatory Services Richard V. Scali, Director ` MASK� ` Public Health Division BARNSTABLE r.A 1639. 0� M.mrza.ue.m vn•H arc<is 3 �� � � raus•os:avtuF•wsr ea+xsrw Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 v II0 Office: 508-862-4644 U' Fax: 508-790-6304 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(RUNS DULY 1 st—JUNE'3'Ofh). _. 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 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. oZ CcaO DATE 6"a 9 ✓ I& FULL NAME OF APPLICANT: . NAME OF ESTABLISHMENT: [A-Wt ADDRESS OF ESTABLISHMENT: R M21 T, RJ �'y 6 fv"'far 0 j MAILING ADDRESS(IF DIFFERENT): S � TELEPHONE NUMBER OF ESTABLISHMENT: �j(fit _)C o l EMAIL ADDRESS:/ i a- 14Mn A.A' s C�rr�-WL SOLE OWNER: ✓ YES NO IF NO,NAME OF PARTNER: �1 FULL NAME,HOME ADDRESS,AND'TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: • N TURF QF APPLICANT Name: Company Address : Telephone#: Email: Q:\Application FormsUiAZZAPP Revl6.docx Page 1 of 2 Number Fee 1212 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Homans Associates LLC 192 Airport Road,Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons 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. 03/09/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Ma,- 08 2016 '12:54PiM HP Fax Pago I • Town of Bamstable RegLdatory Setvices, lUchayd,V. Divectov BARNSrABLE, OZ. Thomas -MVKcau,D.fireccor 200 P&'=stceei;Hyijunis,MA 02001 Office: 900..862-4644 Fam 508-790-6304 APPLICATION FOR MUM TO STOJU kNDIQR YEFLIM - HAZaID SMATERMLS�Qo Bil ACCO-RDAI�TCE Wnlf.THE, TOWN OP-'BA'PNSTA.'GLF G1F-3,.VPXWL OXWI,.ANCE,CI-IAPTER'1013, HALZARDOUS OR STO 1-',1AZA1.W0uS MATEMALS GREMER THANif F1011SEPOLD Q-WV,1T1'1-JES AR:E- REQ13PED TO 0:13TAIN AN ANITUAL PE11MIT(RUNSTULY la—,HJNL, 30(h). APPLICATION FE3('S CATE,GORY I PERMIT 26-11OGallons: $50.00 C-ATMORY? PIE NUMT 111 —499 Gallons: $125.00 0 CAYEGORY3PERIMT 500orlaoreGallorts: $150.00 0 • A late charVc of,110.00 will bc assessed if ASSESSOILS AIAP AND PARCEL r4G. DATE, FULLKANME OF APPLICANT: DbA NAIMM Or E STABLISHMENI": c PAD DRESS OFESTARLISUNIENT: YLAMING ADD RES S(IF,DIFT ERE,NT):., j I�J ,,J� L/ TE LE PHONE NUMBER OF ESTA:6LISBDIE NT: EXAS-1,ADDRESS: I.— SOLE OW ER: IF NO,NAME OF PART WE X F UL1,nom"Homm ADDRE,'S,AND TEIX PHO CORPORATION NAIM, V/'Plj -"v S ?)7) A P (SEDENT Af TRIERASMER 7 CLEARK' IYPREP ARE D BY OUTSIDE PARTY- • ff ��SIGNATU�x PL1CA-N'r_,- Name. Company'Address -tvill Telephone 0,- 2, Emaik. Q:Upplication FormAHAZZAPP Rvv16(Joex Page 1 of ke I Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department Public Health Division MAW, Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt 'Hazardous Materials Payment received: �50.0 (Cash) on 3/9/2016 Business: Homans Associates LLC I ;Address: 192 Airport Road, Hyannis i Note: Category I i i I °FTC*o Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASSRLE, * 200 Main Street• Hyannis, MA 02601 �prED MA�p,O TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ortQ 's Sqo ia-les -ic -W 6_ Date: Location/Mailing Address: 9Z n Contact Name/Phone: .= /6-1-r\-rrrvtms=S 8 - 5O-11 I 1 V F, -re,,_ 4 v-r Inventory Total Amount: ^-6�9k)dD MSDS: Cold License#: 1�12 Tier II : Labeling: CVkQ&,\ Spill Plan: Ye.5 Oil/WaterSepara or: o Floor Drains: `CGS Emergency Numbers: YL S Storage Areas/Tanks: V w ��al t. wVA�\ 4L 61t t l 071f" r Emer enc /Containmen Equipment: ��1 �� ,,,1• btrs�-�P� s Waste Generator ID: d I lk Waste Product: K1 v Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ,- LIST OF TOXIC AND HAZARDOUS MATERIALS Il)� w�-,� c `'Y" +w vtV-� °� Siv\e.C, (4r5'�' Ik7fccta - NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous m7terial use, storage/and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils V Miscellaneous Corrosives C.leaw.rs Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants V Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants fDegreasers for engines& aragges Pesticides: Caulk/Grout/&XV-61,. , k4Z,,i5 insecticides, herbicides, rodenticides Batterya/latteries Phot acid (electrol yt ) ochemicals(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 V 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: o 15'5ve-6 A< NWr16 �5�v►.c.S �IXM.O tM., f� I ''A, Inspector- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FtNE Tom Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS . . A 200 Main Street• Hyannis, MA 02601 Fo39. +°�e00 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: O Q -,5 A.560.eIA;te 5 4�5q V rl-.at C►1le,f Cll-e Date: 3 1 ry Location/Mailing Address: I f of Contact Name/Phone: "7-10 - -Inventory TotalAmount: D S7® �j MSDS: Co< - ►�`��OOJe, License#: Tier II : AJJA Labeling: a� �b �"`� Spill Plan: �S Oil/Water Separa or: AUIA Floor Drains: g -o-o EpiergencyNym rs: yeS Storage Areas/Tanks: &bt I " -,5 �G,ve>3v`s-` Emer enc /Containment E ui ment: 5 i I I oL ,9e"VVVS ev� 51 ? Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze e l y4o1 1e4-4-44-t4 -or53 Dry cleaning fluids Automatic VaInsmission 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 (b Jr IZ+m Gasoline,jet fuel, aviation gas Cesspool cleaners C1� 5 Diesel fuel, kerosene, #2 heating oil Disinfectants �— Miscellaneous petroleum products: (o k2 Road salts grease, lubricants, gear oil 70 Refrigerants 25�0�I 7- Degreasers for engines&garages Z Pesticides: 7 Caulk/Grout/,tA�eg 1ve"/5exiwAt,5 insecticides, herbicides, rodenticides Battery acid (electrolyte)/ atteries 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 2 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: 2 V t G k . Inspector: Facility Representative: ✓vr� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: Y/ 3 I t y TOWN OF BARNSTABLE�� tom TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: ec 4v�+ Ivotkl�,a BUSINESS LOCATION: t Q2 A, rp&<+ {�ay1�t� INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: till CONTACT PERSON: aK c-5 Ct�Q sa6�6d 1� EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: HVAL I p Ivv4s, ,es N/�-7 INFORMATION / RECO`,MMENDA IONS: vl� � Fir District: _ \h\/t.AX D<-4 Q( C�AU\IL �)�� U) --G%nv1, n--1 5�04- OC 16 MVAT 5�h,kk \t a N Waste Transportation: IwsS &cVJ ��I1���oyx Last shipment of hazardous waste: Name of Hauler: &o o,��(.�,Q5 u�. Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes ' Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initial `pp THE Tp�� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMS�BLE,g` , 200 Main Street• Hyannis, MA 02601 0 39 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT tF0 MA'S Business Name: C Cod i Date: 3D /g Location/Mai ling Address: i or a Kvt is — o� a --a-15 2 Contact Name/ hone: ob + ors '% - +d —O!642Sd -•moo-2.'. 5W— v'�J cw t vt4 c.+.o vL, Inventone Total Amount: � °' k32o \\9 SDS: S License#: I o C�`� Z Tier II : 10 a Labeling: 0-%k a Spill Plan: o o -� Oil/WaterSeparator: P3 1 IN Floor Drains: Va 0- Emer ency Numbers: (1 Storage Areas/Tanks: v �� A 1 vG S \A cam( ,CW- J� PA Emergency/Containment Equipment: Dffl AFL Waste Generator ID: iJ I A Waste Product: Date&Amount of Last Ship ment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 23x5, ; 0)) Antifreeze 3�d\\9Akt��X kcleaning 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 40 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, ! a hydrochloric acid, other acids) VIOLATIONS:_ �jk.� �ood rc^rQttn ORDERS: V a� , 2�� �C-eA5& A, INFORMATION/RECOMMENDATIONS: Inspector: - Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS THE kV Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMARS .� 200 Main Street• Hyannis, MA 02601 ,a,q. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT lED MAy Business Name: Date: 3 nn ,, Location/Mailin AdAd ess: 1'7`-f r �-�' 4ny1t w4x 0 2 c� vac +J Contact Name/Phone: ob Sovgw/o,r /V�.yt4S� - S(o2-o166 Ce. / S-$'7 -23'I-f2- SG�f�rCraJ �J� art,4�tt <cy�- `I Invento Total Amount: N b SDS: 7e1� License#: y Z Tier II :AP Labeling: �G���� Spill Plan: Oil/WaterSeparator: ,,(,C,I qx).% �` (Aa Floor Drains: ` e5- CZA<A'Emergency Numbers: StoracieAreas/Tanks: '��rBx'� Y•Tr1L<pT,`�L t��,,���,,�, y, JL N oV, pJ�1,l. , V{,J bo, ,yam Emergency/Containment ui ment: 0 4 %S *a^<e .ti Q o�c Waste Generator ID: N I A Waste Prod ct: _A Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS .�o VlAk,o c NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: —� Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout '�^Qdkxlkok,i.e,� insecticides, herbicides, rodenticides Battery acid (eldctrolyte)/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" ✓� t� � (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: V(-CA ovt, — p INFORMATION/RECOMMENDATIONS: 5 4( V- ' . Inspector. - L Q-�k.\k e_ Facility Representative: ~ WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS i °FIKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B'M�`Eg 200 Main Street• Hyannis, MA 02601 Eo3� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C2S-2.- oo"o- W.V-WAAW-e Date: 7 t I Location/Mailin Address: %"1`I 1,ePolA H t-, Contact Name/Phone: ow �y�� �61 11 0 r a:� So8 - �3�2-©1�,(o cell .o P-2Sa-,2392 i Inventory Total Amount /L-3bQ cd MSDS: e License#: W4$ eXP' Tier II : d Labeling: C�kw�\ \a�x-�� ,p Spill Plan: o oS� Oil/Water Separator: LG�a� cy��el Floor Drains: QS 7` � `e-€maeraency Numbers: Storage Areas/Tanks: 1 Emergency/Co ntainment E ui ment: 0 4ZL- 5�0� Vw Waste Generator ID: Waste oduct: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts 5Yv a Plow «� vLut1� �s grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: `L0o Caulk/Grout`'A PO-Alf- UWA. k — insecticides, herbicides, rodenticides Battery acid (ele6trolyte)/batteries•iv& Photochemicals(Fixers) Rustproofers WAk<lel Photochemicals(Developer) Car wash detergentsta1 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" AJ/� \- (including chloroform, formaldehyde, loX hydrochloric acid, other acids) VIOLATIONS: ZX i<, e e h ORDERS: IN ORMATI N/RECOMMENDATIONS: V-1V-� 1 t o . �ec.ov�,► �j q'0-� C.G.�O `� 01 \ec",.kS Inspector -P-- -F �j1bo I I Facility Representative: ` WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1148 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that CAPE COD WINWATER CO. 174 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 �t ''• Town of Barnstable Op THE ram, Regulatory Services • ~� Richard V. Scali,Director IARNSfABLE, 9� g Public Health Division �FDMA'�0. 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. , Uv DATE v Y APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �4� GOO 2A, NAME OF ESTABLISHMENT GAY ADDRESS OF ESTABLISHMENTj��j�p,� � TELEPHONE NUMBER SOLE OWNER: YES VNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ,O STATE OF INCORPORATION C�CI FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK . SIGNATURE OF AP ICANT RESTRICTIONS: HOME ADDRESS 4W 2i % !A lIv mo. HOME TELEPHONE# CAcache\Temporary Intemet Fi1es\0LKD3\HAZAPP ReQ015.DOC `°F�nE rok8 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA B% $ 200 Main Street• Hyannis, MA 02601 �" i6yq TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Business Name: C Q C,P- �i vl�Je Date: I� Location/Mailing Address: 1-7 orb Av10 1 S Contact Name/Phone: bolo Sow s� O - 2-0 cell ,50 -250-;Z3 2 --e ae L'Sko< Inventory Total Amount: ygD4�1-i�2 00/6 MSDS: 6-5 License#: �/�y� �I Tier II : N)o Labeling: Ck&k k a 4' Spill Plan: tOD Oil/Water Separator: I S O Floor Drains: -ye,,S JI.EmerciencyNumbers: vK Storage Areas/Tanks: a% a«k. ,w t� y ° �O24 Emergency/Containment ui ment: ova ,�2 Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes. Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: 4 Road salts— IZ a grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Z.00 Caulk/GroutA�d,\-A--) (P�f�gl a��.�� insecticides, herbicides, rodenticides Battery acid (electrolyte)/batterie �R" ` 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 0C? Miscellaneous Combustible —qe c6ot wc4rk> Paint&varnish removers, deglossers Leather dyes iavk-80 C06QS Miscellaneous Flammables Fertilizers ,1A -JDo5AQAcs 3Na,Qr 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" Jos kl �Er (including chloroform,formaldehyde, i yq hydrochloric acid, other acids) VIOLATIONS: 3c�A 4 q&.I A'A en — 5JP<,L59— of\,- -40,(� 11 ORDERS: INFORMATION/RECOMMENDATIONS: JS 1 � v2C L�G�• rv''•,.b VeJ(Z.�1- apt- S1�'�,pv� xov S'2Ge�v& —I . �.ayf.l fZ 0� l '�"�• also , 0o 1`^- 5 �j'I CVI. o� Inspector: y k ,(VlA(ct, 5J� 4'/"t l� �� Facility Representative: 61 r� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS t � Date: y / y TOWN OF BARNSTABLELL- ll TOXIC AND HAZARDOUS MATERIALS RE 031STRATMyFORM NAME OF BUSINESS: C4j-- Co ti BUSINESS LOCATION: H4 A„r,Do!'v INVENTORY MAILING ADDRESS: 5t..Vu-� TOTAL AMOUNT- TELEPHONE NUMBER: �DS— 0O(o2 - DI L (o �'o lam .OseJ1e�n CONTACT PERSON: 60 0 5o0� Cor AAh Aa.� �� t "" s EMERGENCY CONTACT TELEPHONE NUMBER: Ce�� �c�-2�c�-:L352 MSDS O SITE? TYPE OF BUSINESS: , INFORMATION / RECOMMEN TIO S: 001.1144-- 19 P T&44A- -CMS, ! Fire District: r1V(y#-V40C,j jyaol ,-e-sb4 -ev-u. lgo1CaI ,o - r 'j y I L-7119414rw% % S t'tD 4% %A aC J en Q 5 vC Waste Transportation: Last shipment of hazardous waste: p P Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS -- Ve, 44+0(6�60e eYKa'I+ 05DS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals(Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes 4 A4 Laundry soil &stain removers (including bleach) �i -�na�araQo�S We4t� Co(IZG}-�o►1 ails , �� Spot removers&cleaning fluids (dry cleaners) Igderb�'or 2k QedDSD�S aKi X�tf,y Other cleaning solvents Bug and tar removers A m,� a Windshield wash I,eA ,Dit , & ��50�i�- WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initia+s�1�1 1 rA � U F MA . lm PRODUCT KAUFMAN 3811 CURTIS BALTIMORE, 410-354-.8600 INFORMATION PRODUCTS AVENUE MARYLAND 800-637-6372` INC. 21226-1131 www.kaufman. products.net , SurePlug Description Cracks should not be left in a sharp V form, Regular Set SurePlug is a fast setting, non-shrinking, particularly where water under hydrostatic pressure Slow Set hydraulic cement compound,formulated to stop is to be dammed off. Fast Set leaks in all types of concrete or masonry If possible, chip the crack into the form of an surfaces; and is particularly designed to instantly inverted V. Mix SurePlug with clean water to the stop the flow of running water. SurePlug requires consistency of putty,using only enough SurePlug the addition of only water before plugging and that can be placed in 15 seconds. Mixing time sealing cracks.Available in three set times of 30 should not take more than 1/2 minute. seconds(Fast Set), 1 minute(Regular Set), and 3 minutes(Slow Set). After filling a crack or hole, the plug should be xept damp to assure complete hydration of the cerrent. Uses Never re-temper or re-mix SurePlug. If areas to be SurePlug is used to plug all cracks and openings patched are holding water under pressure.weep in concrete, masonry walls, dams, manholes, holes should be made at the base of the wall to wells,tanks and stops water seepage at the relieve the pressure. In extremely warm weather junction of walls and floors. It is effective even use ice water to retard and slow down the set,of under hydrostatic pressure. It is also used for SurePlug:In cold weather of less than 40°F.we anchoring bolts, hand railings, repairing cracks in recommend that all surfaces to be plugged, as well concrete floors, and utility structures. as the SurePlug, should be warmed to approximately 70°F, to achieve a more normal setting rate and for best results. Physical Properties @ 75OF Mixing Gradually add SurePlug to clean water and mix with Color Concrete Gray a small trowel. Mix material to consistency of putty Compressive Strength 1 hour . 1,800 psi with no slump. Force material into the crack or hole ASTM C- 109 1 day 3,400 psi using maximum pressure and hold until set occurs. 3 days 4,500 psi. When repair areas are under high water pressure, 7 days 7,200 psi start at the top of the area and work down. Hold 28 days 8,100 psi SurePlug in your hand Until heat is felt and then force material into crack or void. Do not ever add Flexural Strength 28 days 1,200 psi plasticizers, accelerators, retarders, or any other (ASTM C-78) ingredients besides potable water unless advised Tensile Strength 28 days 800 psi by Kaufman Products in writing. (ASTM C-496) Applications Gillmore Needle Set Time Cracks At Floor And Wall Junctions—Widen and Slow 3-5 minutes clean cracks to at least%"in width and depth.. Regular 40-60 seconds Force the SurePlug into the prepared crack with a Fast 20-30 seconds round tool and smooth out. Prepare a cove at the junction. Packaging/Yield Streams Of Running Water- Prepare all cracks 50#plastic pail- .45V(778 in') properly and, if possible, relieve excess hydrostatic 15#plastic pail- .135 ft3(260 in') pressure by drilling a relief hole or by chiseling out 10#plastic pail- .09 ft3(157 in 3) the crack at its very lowest point. After mixing, immediately place the SurePlug and force into the Directions hole or crack that is to be sealed. Start filling cracks Surface Preparation or holes at the top to close the final opening and to All cracks or openings should be carefully seal off a stream of water. prepared by cleaning out foreign matter, and cutting out loose materials. Also the crack must be opened to a minimum width of 1"at the surface. Wherever possible, square out the crack to the extent of making it larger at the base. F PRODUCT KAUFMAN 3811 CURTIS BALTIMORE, 410-354-8600 At that INFORMATION PRODUCTS AVENUE MARYLAND 800-637-6372 moment force INC. 21226-1131 www.kaufman it into the hole prodUds.net and exert . pressure either with your hand or trowel for a full 5 minutes or longer. In some cases,where the water is extremely cool, it may be necessary to hold the plug in place for a little longer. Bolt Anchoring- Use a star drill to make a hole 1 inch to 1 1/2" larger in diameter than the anchor bolt. Mix SurePlug with water, and quickly pour and tamp it into place around the anchor bolt. Precautions SurePlug contains portland cement. SurePlug becomes alkaline on contact with water. Care should be exercised to prevent splashing on sensitive skin.This product is intended for industrial use only. Read Safety Data before using. C:\Users\chjeanmairelAppData\Local\MicrosoftkWindows\Temporary Internet Files\ContenLlE5\S18ZB4EK\172.docApr-14 E f f I Page 1 of 1 Lavelle, Timothy From: chjeanmaire@winwaterworks.com Sent: Monday, April 07, 2014 4:33 PM To: Lavelle, Timothy Subject: cape cod winwater msds sheets http://Wwv/oatey.com/msds/"`3105e.odf 'pC,alf (pvc glue) (40 quarts in stock) t 4't; http://www.oa�ev.com/msds/3402e.pd 5S al p�1 q� (pvc primer) (20 quarts in stock) q htti)://www/oatey.com/msds/OTH09OE5 OATEY PIPE GASKET LUBE.pdf (pipe tube) (15 in stock),, http://www.oatey.com/ipr ducts dr in-and-waste-s stem-cleaners li uid cloroben-aid-ox (60 (Aidox) (88 1 gallon jugs in stock) 0%J10 http://www.dap.com/docs/msds/00079705001 english.pdf (hydraulic cement) (40 5 gallons jugs in stock) Here is the material list and MSDS sheets on our products we have in stock. I am still waiting to get the aerosol paint can msds. If you have any questions please call the office at 508 862 0166 thanks, Craig Jeanmaire This email message and any attachments is for use only by the named addressee(s) and may contain confidential, privileged and/or proprietary information. If you have received this message in error, please immediately notify the sender and delete and destroy the message and all copies. All unauthorized direct or indirect use or disclosure of this message is strictly prohibited. No right to confidentiality or privilege is waived or lost by any error in transmission. 4/11/2014 f Material Safety Data Sheet # 308 SAFETY yt Hercules Chemical Company Inc. INFORMATION 111 South Street HERCULESm SERVICE Passaic NJ 07055-7398 Information Telephone: 1-800 221-9330 Internet: www.herchem.com NFPA HMIS PPE Transport Symbol MIL 1 I Fire Hazard 0 Reactivity 2 0XIDIZER • ,r' Preparation Date 14-Jul-2006 Revision Date Revision Number 0 1. PRODUCT AND COMPANY IDENTIFICATION Product Name Cloroben Aid Ox UN-No UN1479 Recommended Use Drain Field Treatment Supplier Address Hercules Chemical Company, Inc. 111 South St. Passaic, NJ 07055 TEL: 973-778-5000 Company Emergency Phone Number 1-800-221-9330 Emergency Telephone Number Chemtrec 1-800-424-9300 2. HAZARDS IDENTIFICATION WARNING! Emergency Overview Appearance Physical State Solid Odor Odorless Potential Health Effects Principle Routes of Exposure Skin contact, Eye contact. Acute Effects Eyes Irritating to eyes. Skin Irritating to skin. Inhalation May be harmful if inhaled. May cause irritation of respiratory tract. Ingestion May be harmful if swallowed. Ingestion may cause irritation to mucous membranes. Ingestion may cause gastrointestinal irritation, nausea,vomiting and diarrhea. Chronic Effects No known effect based on information supplied Aggravated Medical Conditions Skin disorders. Potential Environmental Effects See Section 12 for additional Ecological information Cloroben Aid Ox—MSDS#308 Page 1 /7 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board Board of Health MAILING ADDRESS: Z,:2!�Z 099y;f d'7'7 r�T/��&-4,14 Town of Barnstable TELEPHONE NUMBER: 7-2 1— �,�' �� P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered w Please put a check beside each product that you store: l/ 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, Jtt- ael 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 ay TOWN OF BARNSTABLE OMPLlANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY p C r ���s (see"Orders") 5.Retail Stores ��(�',. 6.Fuel Suppliers ADDRESS Z �! Z Class: 7.Miscellaneous /'/,,P-/0A/tb,r4UANTlTlES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above.Tanks Underground Tanks 1. IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,dam) G Ml4F�i t �, Xe � ±/ tlieose , # (B) e� 1i Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic (/ Synthetic Or degrease sd"I 1; i/< 70 Miscellaneous: Pat 1'� rqu v DISPOSAURECI.AMATION REMARKS: 1. Sanitary Sewage 2.,Water Supply O Town Sewer ,'Public iJ _ AlOn-site OPrivate 3. Indoor Floor Drains YES ! NO D - O Holding tank: MDC K.G O Catch basin/Dry well 7 O On-site system 4. Outdoor Surface drains:YES NO I/ ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter , . of Hauler DestinationProduct YES NO Person (s) Interviewed Ins ector Date a i TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: / Town of Barnstable TELEPHONE NUMBER: 771, 7.777 P.O. Box 534 CONTACT PERSON: 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 qua tities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES V 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: V 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 f/ Motor oils/waste oils Road Salt (Halite) _ V'- Gasoline, Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, V' Other petroleum products: qLgW, lubricants rodenticides) V- 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 Y 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 r White Copy-Health Department/ Canary Copy-Business .y TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ' lass: '�' 7.Miscellaneous if QU TITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: o ` Gasoline, i2,4 h i 2 �/ Heavy Oils: v waste motor oil (C) anew motor oil (C) f ,G> transmission/hydraulic Synthetic Organics: degreasers 4 7- Miscellaneous: aQ 176 2 - DISPOSAURECLAMATION REMARKS: f 1. Sanitary Sewage 2. Water Supply A ` - o' O Town Sewer OPublic 6101On-site OPrivate 3a 3. Indoor Floor Drains YES Y NO O Holding tank: MDC O Catch basin/Dry well 01r O On-site system ���� 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. ✓ , v Person (s) Interviewed Inspector Date • 'a TOXIC AND HA AR US MATERIALS REGISTRATION FORM 11� � Mail To: NAME OF BUSINESS: og �0 Board of Health � MAILING ADDRESS: 5F/0 26,*?,V ve,7Ad, o 'f��O�A-A--' Town of Barnstable TELEPHONE NUMBER: 7 7f-- . Hyannis, MA 02601 P.O. Box 534 �`i.�CONTACT PERSON: m,P Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli , 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 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) 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 t,"'�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 solvents1 Bug and tar removers c� �.� �d Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers �V ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) 6 f s: C 4 tkAa..a� 2 S t, waste ) new motor oil(C) transmission/hydraulic . Synthetic Organics: degreasers Miscellaneous: DISPOSAURECLAMATION REMARKS: /1._Sa itary Sewage 2.Water Supply Town Sewer OPublic 1nh06 -16 O On-site OPrivate J-3. Indoor Floor Drains YES NO V O Holding tank:MDC O Catch basin/Dry well O On-site system 4. 0 oor Surface drains:YES NO ORDERS: Holding tank: MDC Catch basin/Dry well O On-site system �5.Waste Transporter Name of Hauler Destination Waste Product 1t 1 NO J2. S' &-,,e Person ( ewed Inspector Date TOWN OF BARNSTABLE Ordinance or Regulation BAR -W � WARNING NOTICE Name of Offender/Manager f�iQt 3e Oylre- Address of Offender i i AI'f lZ.ht 7 W MV/MB Reg.. # Village/State/Zip 11 _ 1 Business Name C� Cac, 1��� ttG!' Co ' am/ on 5*{17 20 � Business Address M A)Arf 0 _ 4-4-a9 Signature of Enforcing Officer Village/State/Zip HtYxInniS ACJI/Q6C)I �} j Location of Offense Cape (0j �1n�Jafer ��G11��, I-e n?ei)f Enforcing Dept/Division ` Offense Vj01QA:W G� cw!1 Cc6e M-6 N'tame CW CoAlin eaq Plan Facts Bu+SwI kJA0 + 1►Cer-15'-na. Su m',k Ck9Ai(0,1;0n -fee+M la* �ee Wore, sLX-e 304 This will serve only asp a warning. At this time no legal.action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances,.Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent.violations will.result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE Ordinance or Regulation BAR -W ��� F WARNING NOTICE Name of Offender/Manager Wick -.kav lrM IFS. .. Address of.Offender i Att # 4 t MV/MB Reg. # Village/.State/Zip 4 t �-; Business Name Cape (04-1 LNt� flr� (C) A"CZ am/,pm on 5/17 20 Business Address Aribrf 0 }. J Signature of Enforcing OfficerA41" Village/State/Zip, + tft / U�� r,UU� fir, 1 1 Location of Offense Ccl)e GA' WfnWit( �U� i1 JePar n)g4 F Enforcing Dept/Division Offense V106A.'o GJ iown (03e IN- t tume a1V conlinot'Y q Plan I i , Facts ICU►SOM ra wnu S Sit,{� <M ant �5')o cpil� W rir( ,4S &#e' S t-404 oar ker6n . SA �� C)'41(a'A,6n,-fee+1a% lace fee Wow- 5w 3A This will serve only as a warning. At this-time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, .Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Tow-Ti. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD- ENFORCING DEPT. TOWN OF ,BARNSTABLE = UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION ` #3 OWNER AND INSTALLER INFORMATION ADDRESS: -197—Airport-Road MAP NO. /a PARCEL William J. Scott OWNER NAME: Lincoln D. Scott VILLAGE: Hyannj.s r INSTALLATION DATE: April, 1984 By: Bay State Pipinq Co. , Inc. ADDRESS: 174 Airport Road CERT. NO. Ton ® TANK INFORMATION. -- LOCATION OF TANK: Northeast Corner of Auild na " CAPACITY 6000 TYPE Steel AGE FUEL/CHEMICAL Gasoline TESTING CERTIFICATION C ],PASS, C ] FAIL DATE r } LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND I ZONY OF CONTRIBUTION C ] YES C ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED Cx3 YES C ] NO ,PATE June 30, 1986 CUNSERVATION C x] CHECK,,:jF,-,-,N/A ca�j DATE 1 I r /y /o BOARD OF HEALTH TAG NO. [ �IV ]C ]C ]C ] DATE 3 ? 11t', A ) l PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD �pNK#3 . N . T(a�K TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. ADDRESS OF TANK: Y VILLAGE: .� t//1rfi�11�f MAILING ADDRESS ( IF D I�rF'FER�ENT- FROM ABOVE) : OWNER NAME: /�`/�! / /�11J7" �' `ay PHONE: INSTALLATION DATE: / 7Ca BY:— INSTALLER ADDRESS: -CERT.NO. STANK LOCATION: tacaora:a¢ TANK LOOATION WITH mmummCT TO au2L02NO) CAPACITY TYPE OF TANK AGE . (a YRS. FUEL/CHEM I CAL CI TESTING CERTIFICATION [ ] PASS C ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND r �U� ZONE OF CONTRIBUTION [ YES [ ] NO DATE TO BE REMOVED ,�' mEOM FIRE DEPT. PERMIT ISSUED C ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE ( / BOARD OF HEALTH TAG NO. C ] DATE f/1 o III PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD` TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION ADDRESS: IL -,,-MAP NO. `7 PARCEL NO. r) 4- OWNER NAME: ,�a.l�.°'.- r:�fc'.f'.r-� VILLAGE: ! INSTALLATION DATE: / BY: ADDRESS: CERT. NO. �7"►V v� a 1 I f TANK INFORMATION w ~ LOCATION OF TANK: ~ t CAPACITY -�s�UD TYPE L...r AGE / FUEL/CHEMICAL F(116L 0/ TESTING CERTIFICATION E I PASS E ] FAIL DATE 1' , LEAK DETECTION Cxl CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION E I YES EX] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED E I YES E NO DATE UUNSERVAIION CX3 CHECK IF N/A DATE BOARD OF HEALTH TAG// �`NO. 11 ]E 7 E ] DATE J1 i PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD PCs 3 TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME ADDRESS �92 Ay er\ Nak VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (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 .R. APPROVED Barnstable Conservation Commission a- Sig-Tied Dais '� r. fir •, . [ ( � ♦ ti.... ... •:y ,a. f .,,^-• •. •. . i • fir. <{ ,'a , TM `" < 4.!> - � • , - �`e' V_ :i' ' . - '1f ! , i ` •, '; r/, •' :t >A '� tom/` ` F Ms � `+y�'�. a , •'• ' • - N rfr, .. i9` ' �,. { ',{,, V• .fir' •., � , � !,` � ..a Y•' , .. ' • .March 22, .198447 :.` r•1.; Mr. .John Klimm;°Caairman` r Board of Selectmen t..Y Town of Barnstable Hyannis, Ma. ` r ._ . .. � j•ti • y.. `.. - 'ice e .-. 1 ci t - •� Dear. Mr. Klimm: F The, two b 000 gallon undergrourid�`fue1 tanks for`,.Will'ia'm,Scott; { 192 'Airport Road, Hyannis,'meet`tall of .the``Town Undergroun'd'Fuel ttorage'Regulations r"' `.L'-. a- .-' r - -, r r ..' - • � .y .. ._. � _ '� -V='�'-._ .w.r. .,ram' .+,r. wy,.. t I would like"to "discourage. installation of underground°fuel and ' • chemi ar'tanks; however, at' this time i"f they�comply`•with the a ;+ t„ Board ofaHealtti Regulations,,'we'have no reason for ,denial:. It is antitipated that the town ground ;water; study will fdiiigfiate areas where they,.•should fio be ° nstalledg -Very'-truly".yours, John M.' Kelly -Director ,of Public Health•. �y JMK/mm • ,4 H. Y s, ' •- Y 'i- s . x ,1a j x'd s �:. ,L �.�` ��`}. t*, $rt.'• # F !' Y ,. • I C pp .;+ �• - r.... ', s � e,tr r •f^��. f"M1 < " s F'r t k� - .' } ' .t . ; . . .; .. ' r+• r ; a l • - a (fir L � r C�mninnn�ur I# of faosar4uorffl -- DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION : _ — 1010 COMMONWEALTH AVENUE. BOSTON 11 Barnstable, March 22, 1984 r. _ (Cit9 or Town) (Date) LIC NSE In accordance with the provisions of Chapter 148 of the General Laws, a license is hereby granted to use the.land herein described for the lawful use of the building.... or other structure.... which islare or is/are to be situated..thereon, and as described on the plot plan filed with the application for this license. . Location of land .1.9.2...Ai Airport Rd,.,...Hyann_i S.............Nearest cross street ...�..L..T..A)�PPP.P..................................... William C. (���1�nmberi 325 Wheeler._Rd Marstons M las, Ma. 02648 . .. .. ....... .. Address ............ Owner of Ian ................................ . .... ..... one .. 1 ...... .. . .......................................... Number of buildings or other structures to which this license applies:........... Tru.cki.ng...&..Wareho.usi.n.g...(Fed.era.�'..E.X.Rr s�...................... Occupancy or use of such buildings ..... Underground ....1.2.,.000...ga.1.1.ons...1.n 2 Total capacity of tanks in gallons:—Aboveground............C1.011e......... underground tanks olas i ne ................................. Bind of fluid to be stored in tanks ..............9..................................... . Restrictions—If any: .................................................................................. ny: ........................:............. ........................................... Sel ectmat i • (Signature of licensing autboritp) Town of Barnstable 4EREOF MUST BE UOUSLY THIS LICENSE OR A PHOTOSTATIC PRA E ONITHE LAND FOR WHICH IT S GRANTED r POSTED IN A PROTECTED Health Dept. Town d Barnstable. ME[IO E D _ APR 2- 5 . 1984 F��ceived arld >rec�raadt the above tFrrzO and. _ date in•the Office oT ate Toinm'Cl6rk, To��n;of ;ax>rlstable 'Mg$sadh asetts: Book.,�,, S'�- t�sge.� _ A T>f tde eopy Attu = � � T :ate Clerk