Loading...
HomeMy WebLinkAbout0880 ATTUCKS LANE - HAZMAT 8&'0 ,slf,Fs r� yy„cs j; INE►o Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 a" M„_%.'E•� 200 Main Street• Hyannis, MA 02601 .b,9 e,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 M A'S 1 n Business Name: 04,0e C.e l cv►, ���I �,_ ,� Date:)-:3)-,)6 Location/Mailing Address: 9 a Contact Name/Phone:Pct4,.. C a,-T .SOS•-•?7,_S[d"5 InventoryTotal Amount: e, 1�1'1 o 3 (�� 094A ft, SDS: °��S License#: Tier II : Wo Labeling: Ck -6 I Spill Plan: Oil/Water Separator: Floor Drains: AjJS Emergency Numbers: Storage Areas/Tanks: "S S( , - fi W t�►��1, Emergency/Containment Equipment: ��;J1 �; PL1 !T 1 Waste Generator ID: Yn �o�a y f" g'j oC, Waste Product: L6C-J o o) Date&Amount of Last Shipment/Frequency: 4261 9 L,A Licensed Waste Hauler&Destination: �`` O; / caa,r- ;s o,,,4,b a 4 ho���) 012211&. 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 rake fluid) Windshield wash Po Metter oils H��V-�-��1 y-��5�f 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 S-ySeo Other chlorinated hydrocarbons Laundry soil &stain removers 7 (including carbon tetrachloride) (including bleach) a /6--1" I aleoe- Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) WONT ON S: & C f ►5 Cl rn - Q)a- r e�.w.s �Pc�-s»-�i-1- C'L eaY► ( q� �n - J1�,errt- ORDERS: INFORMATION/RECOMMENDATIONS: Inspector: A Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r .-� �� J , ' ) ; I, c1 �� 3� �� J f �, 16:oo `°FTMEro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BAR;�BLE.g` 200 Main Street• Hyannis, MA 02601 �ATfOMA'�A`0 TOXIC cod, 1HAZARDOUS MATERIALS INSPECTION REPORT Business Name: a c o(O M 60d 1,;flen W�)`Ces 1/arm - d� r Date: /1 Q I Location/Mailing Address: ago AA CKS luf- Contact Name/Phone: Inventory Total Amount: C/ SIDS: eS- v3 uf C'�* License#: 30l "'I Tier II : Labeling: `ku Spill Plan: sir4h /atf Oil/WaterSeparator: N Floor Drains: 1J0 Emergency Numbers: �QS Storage Areas/Tanks: y a � 4CA116n yqS+t oil. Al Emergency/Containment E ui ment: -'S &ratj �5 11001 Waste Generator ID: M Waste Product: 0� ecu} Date&Amount of Last Shipment/Frequency: W/23 14 3ao tll, (p[ tar Licensed Waste Hauler&Destination:_('� of (-nrpOa A 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 fro he Public Health Division. of Antifreeze an l ape �/ Automatic transmission fluid yL Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Vsketor 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 VMetal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) I�DKE Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Q a r Vri N t./1C Inspector: Facility Representative: \ WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS J I `oF�"E'arti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABNABLE.9! 200 Main Street• Hyannis, MA 02601 " i6M "`000 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S 1 Business Name: �a CovweA.A.�e-t4A -Se.TvIc t, Date: 3'� 1 Location/Mailin Add re 8 +� ,j e-S Lv, 2h+i t S Contact Name/Phone: Q r«Az- o! e ¢� r✓�.a r-} 08-171- S'a3� Invento Total A ount: � ( SIDS: -}o)l+ License#: 0t C. Tier II : Labeling: 9F 6 I�te,of/l Spill Plan: 5 Oil/WaterSeparator: ti Floor Drains: KJo Emergency Numbers: Storage Areas/Tanks: 0 ev) 6tz vo 4-5 10 L-,� Emergency/Containment Equipment: . tl V,a' ow. 5 k2 Waste Generator ID: 0 2 Waste Product: &$ -e krau<<e- o, Date&Amount of Last Shipment/Frequency: 22 q0014,1 �t.! �( Licensed Waste Hauler&Destination: C./w �t -I-o�� �e / ►� 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 �x� I o Other cleaning solvents&spot removers Engine and radiator flushes n 5 Bug and tar removers t o Hydraulic fluid (including brake f uid) �� Windshield wash 1b 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 'S Lacquer thinners t —� Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers So PCB's Metal polishes sgo� Other chlorinated hydrocarbons 1160 Laundry soil &stain removers�lpXS (including carbon tetrachloride) (including bleach) -V r\Ih Any other products with "poison labels" t2`j�� 12 ��Z �o (including chloroform, formaldehyde, hydrochloric acid, other acids)�wIOLATIONS: t.C�� n I u� or S�Dr� oar �1�A � d,�S IM�.7�'���C�S c-)1+tLov4 6 -cq . ORDE S: Ol o.f o<k W1 1Q6 � 1� INFORMATION RE MMENDATIONS: e.W J ov .� w6. �t�-� a .c. 14A, SIP11 I X x 01� CoV� w q Inspector: A Vim( Facility Representative:-a >, o/il(f 2,-..--- ei v -V ev •j,, , \ITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS U—7Q, . 15 V-qk 6e6.1CMIJ TOA s�e,(COIA' IW&0 9XY-. eVH,P-r / IKvjd1AAe1 Vy -wem<-. `KE rw�4 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMAT,R- E. • 200 Main Street• Hyannis, MA 02601 MASS. g. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: eq# 0ne1Lrti.¢,,� c-�, Date: Location/Mailing Address: 0&0 A++VeAe_S NY'C(1415 Contact Name/Phone: _Pe-+r�Af- C.,r �e rte�l EtLar 4 SO$ -7"7 1-So 33 Inventory Total Amount: 1'5oo A-'boo M+x� SDS: ar�o•1, 5�5 License#: 301 Ccc`� 3 Tier II : N o 4"mwk5 Labe - (p 12ti 1 W ,�<-aec�w� 0 3 , Q _�: Spill Plan:� ;ec� Oil/WaterSeparator: Floor Drains: f1 a Emergency Numbers: Storage Areas/Tanks: �S�e,1 cQ<v� hv�ceal�c, o• r SS�ror as4c �e,A.o3.,\ ��ra+�s� 100�al 'n�t�� 1v5 Emergency/Containment Equipment: 9,otc vv�.�•��. •e c. wa%L,- 001 q+.t<c.�k �a Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: 1,(,1MVW-2 Olt r1�+5 Ao7c..�. - k.�wlavt.�t�g.k Licensed Waste Hauler&Destination: Clw 0%1 w0 Other Waste Disposal Methods: 5Re �1 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. 2 Antifreeze I- Dry cleaning fluids to Automatic transmission fluid 10 Other cleaning solvents&spot removers Engine and radiator flushes �Sy Bug and tar removers %%5 Hydraulic fluid (including brake fluid)SS — Windshield wash Motor oils Jll'� S s 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 1 Lacquer thinners 1 so I Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables <a���- Fertilizers Floor&furniture strippers PCB's Metal polishes �� Other chlorinated hydrocarbons 1\ 00 Laundry soil &stain removers �SxS� �� (including carbon tetrachloride) (including bleach) k�SS x,\p��ly Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: eu, Co-roA.-e vK 10v1v�- o DERS: J I1 co � �s o5,�-v �.1 au ono 1 b �•e.�.� n �� .e.� ,�. INFO MAT N/RE OMMENDA IONS: l q-4 4.%6�, 1-f---�o -r-'^^''PkOYe,�P--S • Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM.HAZARDOUS 11.Generator ID Numbe/r. 2,Page 1 of 3.Emergency Response Phone 4.Manifasl Tracking Number WASTE MANIFEST � . .» , y / 1-800-899.1038. ` G Q r 5.Genaretpta Name and Mar ingAddress I S /r Generators Site Address(d different than mailing address) rUC•..: Y,1 i:..:(�.r �✓.sal i �; :hlt,}f`� .�.:•���s��'' . Generator's Phone: 6.Transporter 1 Company Name U.S.EPA ID Number CYN.OIL CORPORATION. MAD082303777 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number CYN OIL CORPORATION, 1771 WASHINGTON STREET,STOUGHTON, MA 02072 Faciti"Phone: . 781-341-5108 MAD 0 8 2 3 0 3 7 7 7' gr• 9L U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit and Packing Group(if any)) 13.Waste Codes. HM No. Type Quantity Wf.fVol. ne ,. MA98 STATE REGULATED OIL WASTE Z 2. tg 3. 4 . 14.Special Handling Instructions and Additional information . 24 HOUR EMERGENCY.SPILL RESPONSE 800-899.1038 D.O.T. EMERGENCY GUIDE#128 1PASSED DEXSIL- 15. GENERATOWS/OFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Fxporter,I certify that the contents of this consignment conform to the terns of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement Identified in 40 CFR 262.27(3)(if I am a large quan ge erstor)or(b)(if I am a smell quantity generator)is true. OViraWs/Offeror's Pnntsdlryped Name nature Mont / Day Year —1 16.Ifitarritifforial Shipments F ❑Import to U.S. ❑Export f4 U.S. Pon of entry/exit: z Transportersignature(for exports only): Date leaving U.S.: w 17,Transporter Acknowledgment of Receipt of Materials Transporter 1 Pdnted/Typed.Name r ; Signature j A. / Month [ Y r Q Transporter 2 Printed/Typed Name S Signature M nth Day Year H 18.Discrepancy 18a,Discrepancy Indication Space El Quantity ❑Type, ❑Residue ❑ Fiejecfion❑Partial Rejection Full Manifest Reference Number. 18b.Aftemate Faaltiy(or Generator) U.S.EPA ID Number v U- Fmilihrs Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year a 19.Hazardous Waste Report Ma agement Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) O 1. 12. L 4. 20.Designated Facility 0w5g or Operator. difl ation of receipt of hazardous materials covered by the manifest e s n in Item 188 Printed/Typed Nama Sig re Month Day- Year Xv� 1�4 "d= I klp VS Aix EPA Form 8700-22(Rev.3.05) Previous editions are obsolete. r Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks Lane, 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 1 J d i Town of Barnstable �t Regulatory Services Richard V. Scali,Director . .� � .� Public Health Division wBA aR NSTAv rs B LsaEe N 639 wM°or s� aaa 'V Thomas McKean,Director-, - . 1637 4 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Ak CA 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 JULY 1st-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 • ' A late charge of$10.00 will be assessed if payment is not received by July1st. ASSESSORS MAP AND PARCEL No. .312 ©3.1 DATE 06 .23 12,016 FULL NAME OF APPLICANT: .�-p Coa 6cam v►►r�er i a( Li t�y� � NAME OF ESTABLISHMENT: l� ADDRESS OF ESTABLISHMENT: 5K0AtiV Lan Hvaja e- MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT:r 6 6 EMAIL ADDRESS: mil' e SOLE OWNER: YES ✓NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: _ CORPORATION NAME Col I-Cad COw�w►L'-Y CU( L1 VLe-k% S V0__ h-C PRESIDENT TREASURER CLERK �--- • IF PREPARED BY OUTSIDE PARTY: U OF A I Name: Company Address Telephone#: Email: 0AApplication Forms\HAZZAPP Rev I6.docx Page 1 of 2 `°FT"E►o,,� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • sn M LE.AQq 9! 200 Main Street• Hyannis, MA 02601 163 9el. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Business Name: l PmyK.6 la v(- 62C-V1 CP Date: 3 Location/Mailing Address: R86 . s a , Contact Name/Phone: ci .,uL ri a. - �S'v -'7-7 f- k;D 33 S 3 Inventory Total Amount: by0 4ti 1 kua t� MSDS: J'�5 License#: Tier II : d Labeli Spill Plan: Oil/Water Separator: AIA Floor Drains: A)& Emer_ency Numbers: `f Storage Areas/Tanks: 100 14� a w�Gs ('-e /4v,!.�Glw,n J-AJ-6 t- 6<sA-(,A)0f s , of l5o O&WIS 04 I-POIV4� Emergency/Containment Equipment: sa,)/ k, }-,? Waste Generator ID: f Waste Product: 01 Date&Amount of Last Shipment/Frequ ncy: 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)S� --� Windshield wash Motor oils 1/(K 03 'Pole 4A)4cs� 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" 10 �>L P Me,.., +<,,eJLe,$ (including chloroform, formaldehyde, hydrochloric acid, other Aacids) n VIOLATIONS: SP, Cow-1--UytLV �au.- mob ' aV to I-e-- t"�eg�s�crp�X ORDERS: t-+ 5A. j Avt. ', 1 S v! k) ✓� e o s mess. RP-ori -s .e,-r o-s I NFORMATION/ ECOMMENDATI NS: of \\A- 0W-- .e a hs t' O 11 dl,,(jv4,CS 45 ' c v� +.�" . asfL , l ,� , Cke e V� rti�ew�-5 a vL/� �Pr2 �/ b�clG hoof. `-�ILcae �k��-2 '` 4�'LG.G .�D.> Inspector: 1/.�1 ale r5��r�� a, ��� Facility Representative: In A. WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS l v\ v Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks Lane, 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 Flow Town of Barnstable Regulatory Services ENTERED INTO ti • \°� Richard V. Scali,Director 2015 ` ` ' ")° Public Health Division JUN 17 � �. N3 QUICKBOOKS '° ' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601M. m Office: 508-862-4644 ; Fax: 508-790-6304 Application Fee: $100.00 ' ^� ASSESSORS MAP AND PARCEL NO. � 'L O DATE SU ne ZO, 2,015 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 0-Opp e O c)6 C o m merd a 1 U n(n Svc.) r1C . NAME OF ESTABLISHMENT • ADDRESS OF ESTABLISHMENT 88V A+ I VCY_S L a1-Ne 4±1 g h Y\t S TELEPHONE NUMBER SOLE OWNER: ' YES v NO Y IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: Eh S o-I tev Rck . s�env)1 AVIne -a- -E V�a 2 mOY-C Oster vi l to IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. *ALA R L-'5q STATE OF INCORPORATION M �- FULL NAME AND H ME "DRESS OF: PRESIDENT D - � (cL6ove—). TREASURER a CLERK V SIG ATUREbJbAPPLICANT RESTRICTIONS: HOME ADDRESS 2 S 5rnn ke Va l lay k HOME TELEPHONE# 1,6.31 C:\cache\Temporary Intemet FileAOUDN AZAPP Rev2015.DOC pft ►off Town of Barnstable Office:508-862-4644 o� Public Health Division � enRM SAS. . Fax:508-790-6304 D` 200 Main Street• Hyannis, MA 02601 (►� (, q�u o%%-'I'c% Fo39. r TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ca l..00t o►" Date: Location/Mal ling Ad ress: O +A-jc-t.s we- Hyqnlvs Contact Name/Phone: a,'kkcl- CInayk SOO ? I -Sy33 Inventory Total Amount: ^' 9`�� MSDS: r-5 License#: fo ve-r Tier II : 0 n y Labeling: D 4 - VVA o\\ 0A0 Spill Plan: 2 Oil/WaterSeparator: 0 Floor Drains: o Emergency Numbers: .� l (��.. Storage Areas/Tanks: d + 4,CtX-C&, Emergency/Containment Equipment: S Q.\1 \A\A,s W ioAx�5 ova, S,k�i Wwaste Generator ID: pk Waste Product: Qkf6E- o.k Date&Amount of Last Shipment/Frequency: S67aa1 A- Licensed Waste Hauler&Destination: Other Waste Disposal Methods: 7<Cr A5 5 w G�0,1 LIST OF TOXIC AND HAZARDOUS MATERIALSN NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws0 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 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, r hydrochloric acid, other acids) VIOLATIONS: \0� .e6t oo &< ,1 ORDERS: IN ORMATI N/RECOMMENDATIONS: C¢ 2 v,\ + a o Oc�� \. vVpE + o co. 1 1 S." - � ,5 C>5 Covv< a.h moo,/ e- cam fv4- Vt)%-V4�Al M !P� . �foce_ -� Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE BAR_w 4 ,221 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager r. t ,._ "} ,,,i Address of Offender MV/MB Reg.# Village/State/Zip l y Business Name Ram/pm, On ! 20 r , .. ', Business Address am jA A Signatures/bf Enforcing Officer Village/State/Zip 0\/'� (,V1 > orl t, t 1 r� Location of Offense Enforcing Dept/Division Of fense M i e, e--- r/411 0( Facts I Cf�1�I r ?I-f n- .�hk 3_ L.h(f ' / , ^fi / MA ^t<._ j 1154 1-M 044 m)14 ,►4 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 Town. ,' WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BpR_W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name r' am/pm, on 20 Business Address Signature _of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense �_ ► r 4 �_ , . Facts "". '�•. , i { 1j},• ° ,3f{ --+ 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 Town. WHITE-OFFENDER CANARY-ORD-/REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCIN3 DEPT. Date: ( I I /3 TOWN OF BARNSTABLE sit>oV%.- TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: ( at- Cod, (fowIrm4re-i4j /,)V%e—VL -Lute. BUSINESS LOCATION: I..ALVU . Pva.,nv% s INVENTORY MAILING ADDRESS: haw TOTAL AMOUNT: TELEPHONE NUMBER: SO S --7`71 - ,moo 33 — 8lO 9Q 1 CONTACT PERSON: aft,e- k E:144,,r-:L EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 6 Cc I&I ZAVy1zXrjye 5 INFORMATION / RECOMMENDATIONS: +Fire District: �v'r C,5ca1 r2o12 re e,v ( t 3. 5ci , , cl{-Arc 4KX o{ l a VIVI 15 Jrti vF atu•a1 +� 10 ( �vt rtvt�'I ${-o f �ri.`�'r �,t- -1'ro,., 1 t-f or !'aVIS o batk osv I, t I� ,yl +Jt•�.�C G tM�t,��ie��S ,hd'#" ,K e.l✓ ,vl c•x!s�-Y �.b C'K, r+a i�l,�'e�`y. Waste Transportation: 4—YA Last shipment of hazardous was : 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 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 sQ,� .�- lk e!",�t S Laundry soil &stain removers -)f' (including bleach) L A AA A Spot removers&cleaning fluids (dry cleaners) — fd 1) k lg gykI le, cyL S,+-e— Other cleaning solvents Bug and tar removers — y,o, hAvt�, aPL-s Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials L2-03 °F�►�►oy� Town of Barnstable Office:508-862-4644 Public Health Division �J Fax:508-790-6304 BARMA.Bq 200 Main Street• Hyannis, MA 02601 '° t639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT TFD MP'� /' J Business Name: m ita ]I I-t Date: O®P31A I Location/Mailing Address: Contact Name/Phone: bro ti O Inventory Total Amount: 1 o MSDS: License#: _3ol — Tier II : M0 Labeling: U Spill Plan: Ale& Oil/Water Separator: Q 1 W Floor Drains: Emergency Nu bers: ✓ Storage Areas/Tanks: te L,q � Emergency/Containment Equipment: ta, ED r aste Generator ID: Waste Product: t Date&Amount of Last Shipment'Frequency: Licensed Waste Hauler&Destination: ®i Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the Geheral Laws o�azardous 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 t/ Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 4 Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene,#2 heating oil V 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: V Inspector' Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks'Lane, 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 II �r { t 4 Town of Barnstable Inspectional Services BARNSTABLE • pf 1NE io rs a u osen rtUu CONSrt0A4Y^SITflSE "��, Public Health Division 6 -2014 1 BAMMBM = Thomas McKean, Director 1639. J 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 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 JULY 1 st-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 Vvs *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. )Z 1 2. IS THIS A PERMIT RENEWAL? /YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. Yvic 4. FULL NAME OF APPLICANT:. 0-60 Oo mmudc�1 Lien 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 9'S0AtA,-UfV-S t AAC, 0qdJARCS &A,�- 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 02,661 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: ey `' c, 0 CC-65 C 10. SOLEOWNER: v YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TEL PHONE#OF: CORPORATION NAME C• yX-- 50$(bg30I&PRESIDENT C)- jf4::PPt aVAa L I ndd d O$-13 T 4CI1 TREASURER 2(� Yv>I 5 CLERK +) 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS IL: SIGNATURE OF APPLICANT DATE C76I.3b 12 Q 2 0 Q:\Application Forms\Haz Mat Appli Draft Jan20l9.docx Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commer al Linen Service, Inc. 880 Attucks Lane, Hyannis, A" Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. - ------------------------------------------- ---------- ------- ------ ------------------------------------------------------------ ------- ------ ---------------------------------------------------- --------------------------------------------------------------------------------------------------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 t` THOMAS A. MCKEAN, R.S.,CHO Director of Public Health r 1\ Town of Barnstable Inspectional Services BAMSTABLE f Public Health Division 16J9-703 �:r . r Thomas McKean,Director MAWL } ems` 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 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 lst—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CJ' (? CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 O'�^ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 !�d Yl �, *A late charge of$10.00 will be assessed if payment is not received by July 1st. f� 1. ASSESSOR'S MAP AND PARCEL NO. 2— d� 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: �aq e C 0d c omm er c l ak Ll n ey,\ kV\11CejA(. 5. NAME OF ESTABLISHMENT: _ SQ11Y1 D ,r 1 6. ADDRESS OF ESTABLISHMENT: ® A do t— Vm e (x"V-65 —W O260) II' 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: e_In avt C C65 . 10. SOLEOWNER: VIYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: , CORPORATION NAME C C O m eY Ca ak \J VL C - PRESIDENT D-:jief 1( -E t/ Z ` 1 t KS CTREASURER 1 2 1 I V 1 C&, ®dV r�--e� CLERK I 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS Wdocx SIGNATURE OF APPLICANTE 0 6 I b,5 �2D I Q: q �Application Forms\Hu Mat App Revised 09-10 Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks Lane, 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 10w of B nsxable qV $�,� I, egu'atory Services Richard V. Scali, Director Public Health Division BARNSTABLE * BNiNSTAEIF.fli(fEi1VlLLE.NiUR•HYANHLS BARNSTAWZ, = Thomas McKean Director ""�°"'""�1639-2�'" � 1639�--772014 --200 Nlain Street,,Hyannis MA 02601----- ---_._----_-__-- r� Office: 508-862-4644 Fax: 508-790-63M1 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS ; IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER�,.08, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS J.,;'' MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). 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 O 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,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS ST GE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES ' NO. �+ 4. FULL NAME OF APPLICANT: �Qpe- � ( oyy\m 0-6 ak LAn ea cS ayi& V\c 5. NAME OF ESTABLISHMENT: 'SGL m , 6. ADDRESS OF ESTABLISHMENT: n e- , A 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT, 6©K - 1- 1 — S 0 '�3 9. EMAIL ADDRESS: eI°1 V l� AA 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND ELEPHONE#OF- CORPORATION , 1 - NAME C ��'1VY �C�k t�l� �L1 i'�(', PRESIDENT �e V Z t I Q v S 1'LS 1 TREASURER CLERK V 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS MAIL: SIGNATURE OF APPLICAN DATE ()E,12 J 120) T Q:\Application Forms\HAZMAT APP 2017 REVISE Anx Ira CV � �t 'J Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks Lane, 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 06/30/2018 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 ' ow of B4nstable p / TROeg atory Services Richard V. Scali,Director IHE Public Health Division BANTAM, • 6FNN54lLLitE.,xLkl49LLE.CONR•HTU I:Ii� YiJ(S:U'!5 I:OS•OSi:.Y1LLE•Yl31 Pa:nSl ��M = Thomas McKean,Director 1639-2014 1639. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 oC"/ ~;(N 14 Fax:-508-790-630 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS ": IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER MRS, 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 30th). APPLICATION FEES - CATEGORY 1 PERMIT 26- 110"Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 El CATEGORY 3 PERMIT 500 or more Gallons: $150.00 M 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.O. 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 HOU EH LD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �(� Q 12P c d ol o m nn ercial V n eh Sewice. Inc . 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: S b A t;tV CX-S L CDC hf4 Q Y n i( .M 4 O 2A Ol 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: b 0q) 711 5 O3 3 9. EMAIL ADDRESS: p ey,,GCrE e c c C 15. co m 10. SOLEOWNER: /YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 1 CORPORATION NAME cape cc) d c O I Q Uri eh S eV-V( 11'1C . PRESIDENT LV TREASURER CLERK t 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 06 / 13-1�0 4 Q:\Application Forms\HAZMAT APP 2017 REVISED. cx Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880 Attucks Lane, 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 5 1 Town of Barnstable °FWE t Regulatory Services Thomas F.Geiler,Director B"' �"a'� ' Public Health Division i°rfn'59 ° 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. 31IJ03f DATE J�DT L 5 1.)-0 t - APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT J C •G"� NAME OF ESTABLISHMENT C Q Cd 0 Yh Vh U � �k h CSU VC C r ei ADDRESS OF ESTABLISHMENT_ S 0 p-4uct S 1 Akf o. 0' Onr-01 e M d+- UI&O I TELEPHONE NUMBER 5 D �Q �'� �j ®�5 3 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.��- STATE OF INCORPORATION FULL NAME AND HQ E ADDRESS OF: PRESIDENTb S e L,A IE, 5S yhd ke V0 11t j 'A J- V J `r�v l ll t f' - 02 TREASURER CLERK S�nv t G SS SIGNA E OF APPLICANT RESTRICTIONS: HOME ADDRESS a5 5M44 Uau!� K�. HOME TELEPHONE# sp V 4-24 1(034 M55 r Haz.doc/wp/q 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 five to seven O working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 260 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 amount of$100.00. Please make the check payable to Town of Barnstable. The check must be mailed to the address.listed above. Allow up to four days for in-house processing.. For further assistance on any item above,call(508) 862-4644 Back to.Main Public Health Division Page r Rom:Patric4Ehart Fax:(608)772-481 i To:Town of Barnstable Fax: +1(508)790-6304 Page 1 of 3 09109i2014 10:03 FAX Date: Q9i09/2014 Pages including cover sheet: 3 To: Town of Barnstable From : Patrick Ehart CCC LS 880 Attucks Lane Hyannis MA 02601 Phone Phone (508) 827-1717 * 101 Fax Number +1 (508) 790-6304 Fax Number (508) 772-4817 Please find enclosed the Application for he ?ermit to store hazardous materials at Cape Cod Commercial Linen Serv_ce, Inc. A check is being mailed today. Taank you, Send and receive faxes with RingCentral, wAw.ringcentral.com Frc:1n:Patrk:k"'Chart Fax:(508)772-4817 To:Town of Barnstable Fax: +1 ;508)790-6304 Page 2 of 3 09109r014 10:03 Town of Barnstable Tod Regulatory Services Thomas F.Oeiler,Director AM ` Public Health Division i63q. ♦�� ► ° Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS ALALP AND PARCEL NO. 3ti O _DATE SEPr L-11 5`fit? <<j' APPLICATION FOR PERNIIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT IQ�3� NAME OF ESTABLISHMENT ed� (QYh1%UCkaJ r\ C_,u%A0 c In 0 ADDRESS OF ESTABLISHIVIENT Q A-�VctS Loe.. 61nr1 E I I M 8- nbo I TELEPHONE NUMBER_ to T -I-) I s®-;3 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. 04-334 k4 5`1 STATE OF INCORPORATION M� PRESMENT AND � - rvtADDRESS 1-7 P'5 syvwkA yolk V. y j llli e w *b55 TREASURER CLERK. rn/ t G SS A64��&L�r SIGMITME OF APPLICANT RESTRICTIONS: HOME ADDRESS a�j J MO k �ak ��- °�J�"`"r'�` HOME TELEPHONE# 3 p t 41.1- ,G34 Fro.p:Patrick Fhart Fax:(508)712-4817 To:Town of Barnstable Fax: +1 ,508)790-6304 Page 3 of 3 09I09r014 10:03 if $az.do,/wP/4 MMIL-IN REQUESTS Please mail the complete application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc). ln. addition, please include the required fee of $100. 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 Pubfic 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 amount of$100.00. Please make the check payable to:Town of Barnstable. The checIt must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above,call(508)862-4644 Back to Main Public Health Division Page Number Fee 301 THE COMMONWEALTH OF MASSACHUSETTS $10o.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Commercial Linen Service, Inc. 880Attucks Lane/PO Box 111 W. Hyport 02672, 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 r Town of Barnstable Regulatory Services Thomas F.Geiler,Director ` B" MASS. Public Health Division + Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862 4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3 1 Z/U3 ' DATE za 1 2� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT D. -1-E F F t AA V—T NAME OF ESTABLISHMENT (!A-PC— dQ 0 N M L.£ P-0—to�L 1, L6 &6•i )1J(-- ADDRESS OF ESTABLISHMENT g WC) TUC Ls b4tjE TELEPHONE NUMBER l J' M) 4�I - 509 SOLE OWNER: YES )� NO uu� O IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDREW$OF ALLw PARTNERS- 4" " IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. `�JJ''q 8 qI -Cj STATE OF INCORPORATION 1AA FULL NAME AND HOME ADDRESS OF: PRESIDENT 43-Ef-FAEI TREASURER 'i CLERK A de- ' tA- SVNMtRFOF APPLI ANT RESTRICTIONS: HOME ADDRESS ;ZS—L5/4()Lt l��Ll " - HOME TELEPHONE# 6�0 Ll2 8'- 3� 6 1 Number Fee 362 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that F. W. Webb Co. 880 Attucks Lane, 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 June 30, 2009 unless sooner suspended or revoked. -------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health coo �I r Town of Barnstable Barnstable VE'°wti Regulatory Services Department o ;edcaQdv Public Health Division BAMSPABMHAM 1639. ` �m��� 200 Main Street, Hyannis MA 02601 A�fb � 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 "T7 ASSESSORS MAP AND PARCEL NO. I v J 1 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS o m FULL NAME OF APPLICANT NAME OF ESTABLISHMENT /- �t/G✓�� ��g ; Ri a"` U,, ADDRESS OF ESTABLISHMENT �IJC. 1 L�N�' DO o r- TELEPHONE NUMBER �� 72S ' '3 ~� SOLE OWNER:_�__YES NO wj pope- IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: cok>r t�-Dokss - / �u Ali. oa_sue i�e"", o� -6eQ6r � , A11 0173-a IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. I -I�� 91 a STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT 'SL-`l P 6 PL-' TREASURER 13oR ITWCCJAR_c)A2- CLERK 4 U, tip, SIGNAT F PLICANT RESTRICTIONS: HOME ADDRESS I7 MWOO Ctle- 4-°770, J HOME TELEPHONE# 22�./_ ��lA Q:\Hazmat\Haz Mat Application2008.DOC r l EMERGENCY SERVICES Local Fire: (508) 775-2323 Local Police: (508) 775-1212 Local Ambulance: (508) 77&2323 National Response Center: (800)424-8802 Other Emergency#'s F.W.Webb local emergency#: (508)294-8232 F.W.Webb Corp office: (781)272-6600 Local DEP office: (508)946-2850 Clean Harbors: (617)935-9066 F.W. WEBB COMPANY SPILL CONTINGENCY PLAN FOR HYANNIS BRANCH 1. If the nature of the material and/or spill requires so,evacuate the area immediately. 2. Shut off any electrical equipment in the area. 3. Remove any potential ignition sources from the area and turn off all operating equipment in the vicinity. 4. Cover all drains to prohibit material from improper drainage. 5. Contain the spill by use of absorbent material, apply additional to absorb. 6. Contact spill response firm on the Emergency Services phone list. 7. Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from liquids 8. Label all containers with the type of waste and the start date of accumulation. 9. Notify appropriate agencies and F.W.Webb Co corporate office,listed on Emergency Services phone list. 10. Once spill has been controlled and materials collected and secured, inspect the area for cleanliness and decontaminate all equipment used in the clean up. 11. Replace all used materials and ensure all response equipment is in good working condition. 12.Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 13.For any spill greater than the reportable quantity,or 25 gallons,whichever is less,this plan shall be implemented and proper records of actions shall be kept on-site as a prescribed. 14. Spill clean up equipment is located in the showroom 15. The following is a list of the spill equipment on site: a. spill containment kit b. personal protection aumpsuit,boot covers,gloves,glasses) c. First aid kit in warehouse office and supply closet e. Eye wash kit f.Fire extinguishers throughout the facility Town. of Barnstable Regulatory Services Thomas F. Geiler,Director 1 .. wt , Public Health- Division Thomas McKean,Director 200 Main Street, Hyannis,MA.0260.1. aKOffice: 508-862-4644 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 / Ue,/ -:ZC, GJ s-1 ZeAljt4ZZA NAME OF ESTABLISHMENT '.V'1f ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER 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. �'f L/9 STATE OF INCORPORATION / -5 "-C 4v.`--XIT FULL NAME AND HOME ADDRESS OF- PRESIDENT &I',,1nJ TREASURER CLERK 5,1-L SIGNATURE OF APPL NT RESTRICTIONS HOME ADDRESS G UA e`i.,C f a HOME TELEPHONE# 5'09 Haz.d" ocTwpPq —S fje J 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 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. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 Number Fee 362 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that F. W. Webb Co. 880 Attucks Lane, 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 June 31, 2008 unless sooner suspended or revoked. -- ------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAULJ. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services Thomas F. Geiler,Director i M&13 B Public Health Division 639, " Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 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 / /WZr NAME OF ESTABLISHMENT ��t/G✓G� � C� ��`7 k� � a _x. ADDRESS OF ESTABLISHMENTS! .TELEPHONE NUMBER 7 75 3"d a I TIP on SOLE OWNER: YES ENO co w r IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF A L PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT 7�H ti P01E— TREASURER Ti oO 112t/(C-(A9d,tA5- CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Cl AIM 0, I--- C,CUt 1JPZ ` HOME TELEPHONE# 3rOk�- b --- F.W.WEBB COMPANY SPILL CONTINGENCY PLAN FOR HYANNIS BRANCH 1. If the nature of the material and/or spill requires so, evacuate the area immediately. 2. Shut off any electrical equipment in the area. 3. Remove any potential ignition sources from the area and turn off all operating equipment in the vicinity. 4. Cover all drains to prohibit material from improper drainage. 5. Contain the spill by use of absorbent material, apply additional to absorb. 6. Contact spill response firm on the Emergency Services phone list. 7. Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from liquids 8. Label all containers with the type of waste and the start date of accumulation. 9. Notify appropriate agencies and F.W.Webb Co corporate office,listed on Emergency Services phone list. 10. Once spill has been controlled and materials collected and secured, inspect the area for cleanliness and decontaminate all equipment used in the clean up. 11.Replace all used materials and ensure all response equipment is in good working condition. 12.Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 13.For any spill greater than the reportable quantity, or 25 gallons,whichever is less,this plan shall be implemented and proper records of actions shall be kept on-site as a prescribed. 14. Spill clean up equipment is located in the showroom 15. The following is a list of the spill equipment on site: a. spill containment kit b. personal protection aumpsuit,boot covers,gloves,glasses) c. First aid kit in warehouse office and supply closet e. Eye wash kit f. Fire extinguishers throughout the facility Il f EMERGENCY SERVICES Local Fire: (508) 775-2323 Local Police: (508) 775-1212 Local Ambulance: (508) 775-2323 National Response Center: (800)424-8802 Other Emergency#'s F.W. Webb local emergency#: (508)294-8232 F.W. Webb Corp office: (781) 272-6600 Local DEP office: (508) 946-2850 Clean Harbors: (617) 935-9066 Number Fee 362 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that F. W. Webb Co. �Attucks Way, 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 June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. June 19, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health DATE DESCRIPTION AMOUNT DATE DESCRIPTION AMOUNT Z fw }- �Y1 Y 1G1 t TOTAL INVOICES iOra0 CASH DISCOUNT EARNED 1 AMOUNT PAID o ACCOUNT No.,, DISTRIBUTION ACCOUNT NO, AMOUNT ACCOUNT NO. AMOUNT ACCOUNT NO. AMOUNT ACCOUNT NO. AMOUNT I f Town of Barnstable Regulatory Services is y.V'YM. :e(;Sy• ', ` Thomas F. Geiler,Director Y Ya Public Health Division :1�,- Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax:.508-790-6304 . Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3 � ,3 / DATE 51ZNQ lP APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT M Cr C Q O In NAME OF ESTABLISHMENT 1E- W VQ 60 b Co•m W_n(-A ADDRESS OF ESTABLISHMENT ���,V � '+''�G�.S !� ►�'� TELEPHONE NUMBER �'� - �� O �4T SOLE OWNER: YES "✓ NO _ IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: =i t -k r- r IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION QS G CV)uw�-+S FULL NAME AND HOME ADDRESS OF: PRESIDENT J��'�(�Q-C)ne Le 6;—\I'e0 1 fQ 'Dr VC )G n VCrS + Yv11�- TREASLWR -_QY)ee.r•� i'n1yCC\GY1CjnC, 1-1 1 oe0QX LG0e- , k) �OICI�n , rY pr CLERK Ck vl e S I LA O v(' D c v i-j r )p• .: SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE.# fia:..dow'wa'r, i t MAIL-_IN REQUESTS Please mail the completed Pl 1 ed application fo�n to the address below. P PP 1 w. Also include copies of your employees food sanitation training certificates. 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. Also, please fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in- house processing. For farther assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page y , COhlPLIMCE: . CLASS � Lllarine,Gas Stations,Repai.r OFBARNSTAB E; Printers satisfactory' 3. , Auto Body Shops BOARD - OF HEALTH 4. Manufacturers unsatisfactory- >/ � see"Orde�s") 5. Retail Stores COMPANY t��Vl ( hay . �'3 "'' i ''�" 6. Fuel Suppliers � 7. Miscellaneous ADDRESS ''a �� ��` '" Class: �^✓ QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) Case lots Drums AboveTanks Undetground Tanks MAJOR MATERIALS IN UT IN 0' IN N Q1 e s ? Fuels: Gasoline, Jet Fuel (A) ' Diesel, Kerosene, N2 (B) l Heavy Oils: waste motor oil (C) new motor oil. . (C) transmission/hydraulic Synvth•et1o7-01f9a'rics•t ,�, 2:�k �,. - , fit, -k tJ Miscellaneous: - . , DISPOSAL RECLAMATION REW.RKS: 1. Sanitary Sewage 2. Water Supply `'�iz"`h �. �L_ O Town Sewer Public On-site Q Private 4-va 3. ,Indoor Floor Drains: YES NO �3A�- ' �"' Q Holding tank: MDC OCatch basin/Dry well _._.__�_._ _._. .._____... 0 On-site system 4. Outdoor Surface drains:YES &I. - O rHoldink• tank: MDCOA Catch basin/Dry well 16�� ��''''''— ----------= - t. _ z"IJOn-site'system S. Waste Transporter ' icensed? Dpstination ,w-gte Product_ K A ,A �. Persons Int.ervzewe '" Inspector Date 12 23- 81 _ V- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OEE-CE 20 RIVERSIDE DRIVE,LAKE E, P2 7 1 O '4¢ 27- MITT ROMNEY MflD ELLEN ROY HERZFELDER Governor 5 2003Secretary KERRY HEALEY EDWARD P.KUNCE Lieutenant ern r7 t B ARNSTABLE CONSERVATION Acting Commissioner DMf rp k�+ .. V� ILLJJY February 25, 2003 Paul DeRuyter, Trustee RE: BARNSTABLE-BWSC/SMP RTN 4-16597 Sun island Transport_ 10 Hadaway Road 10 Hadaway Road TRANSMITTAL #W031361 Barnstable, Massachusetts 02601 NOTICE OF PERMIT EFFECTIVE DATE Dear Mr. DeRuyter: Enclosed please find the first page of the Permit that you accepted and signed for the above- referenced site indicating the Permit's effective date of March 3;2003 and expiration-date of March 3, 2008. The effective and expiration dates are calculated based..upon the-date the Department of Environmental Protection, Bureau of Waste Site: Cleanup (the.Department), received the signed Tier IC Permit from you. Please attach this page to the�Tier IC Permit already in your possession. The Department urges you to review and familiarize yourself with the terms and conditions of the Permit and the Massachusetts Contingency Plan (MCP), 310 CMR 40.0000 et seq., in order to complete the required response actions within the timelines set forth therein. Failure to comply with the deadlines in the Permit and MCP may result in the Department taking enforcement actions against you,including, but not limited to,the assessment of Administrative Penalties. Please be advised that if a Response Action Outcome (RAO), pursuant to 310 CMR 40.1000, or Remedy Operation Status, pursuant to 310 CMR 40.0893, can not be achieved at this site prior to the expiration date of this permit, an application for a Permit Extension must be submitted to the Department. Such application must be filed with the Department 90 days prior to the expiration date of this permit. If you have any questions please call Mr. Michael Whiteside at(508) 946-2704. Sincer erard M.R.:Martin- Chief Site Management&Permitting Section M/MCW/re This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep Q� Printed on Recycled Paper i �,,• Barnstable-BWSUSMP RTN 4-16597 Page 2 of 2 Notice of Permit Effective Date CERTIFIED MAIL NO. 7001 0320 000.1 4832 6597 Enclosure cc: (without Enclosure) Board of Selectmen 200 Main St. Hyannis,MA 02601 Board of Health 200 Main St. Hyannis, MA 02601 Thomas P. Army ENSOL, Inc. 100 Treble Cove Road N. Billerica, MA 01862 DEP-SERO Attn: Cathy Kiley, Permitting Branch Chief Data Entry