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0076 BARNSTABLE ROAD - HAZMAT
{S Number Fee 1046 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Franciscos Auto Detailing 76 BARNSTABLE 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 • Tow of B nstable - egulatory�ervices Richard V. Scah, Director ' �T BARNSTABLE 9 Public Health Division • WNSTAOLE•fBREhV -COTUIT~15 BARNSTABLE. = Thomas McKean, Director M'�1.639 o 4 '°Ten r�►•+° -- -- - - --2001VIain Saeet-Hyarirus-MA-02601--- -- --- -- - �D�- 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 9 I/ S 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?�YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: r rL n cAj,�C p Pe f 21 CCa. ()1 a Con G2 j G 2ko 5. NAME OF ESTABLISHMENT: Ft�Q, U s (,0 S {o P pc, ( 4-q,; 6. ADDRESS OF ESTABLISHMENT: -6 6a MS-�O, (Z H -d n n i C . M A- 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO 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 APPLICANTJ&W&ADATE o 6 — n- - 1 r Q\Application Forms\HAZMAT APP 2017 REVISE .docx • Fee 1046Number THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Franciscos Auto Detailing 76 BARNSTABLE 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 06/30/2018 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 Tow of B nstable C� 3331 Reglatorylervices Richard V. Scali,Director 1 SHE T , �a'" Public Health Division BABSTABLE Y - Bf.NNSfMBtE•iENIERVILLE•CONIT•M'AM1N.IS f !uRSTV?.5 M1.CIi•M1iaVIllF•Wi51 BA:NiTiBIt • ASTABLE. Thomas McKean,Director 1639-2015 1639.�s`� 200 Main Street, Hyannis,MA 02601 Dg -tea Office: 508-862-4644 Tax: 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 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 C �' CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: f_R A N C l SCE 126_p C—IRA Da CON G E i c i 5. NAME OF ESTABLISHMENT: ER-A(V C,i s C-C) �S PrU ro b(f T4 i ( _ 6. ADDRESS OF ESTABLISHMENT: _'6 rns 4-CzkI-C, &L 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: C S2 o 3 6 Q c 3 8' 9. EMAIL ADDRESS: 10. SOLEOWNER: _,KYES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE (�- Q:\Application FormS\IIAZMAT APP 2017 REVISED.docx °Fn+e►ors Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 "M �E. ' 200 Main Street• Hyannis, MA 02601 Fo + TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ��a�c-%S c.03 A-40 1 �,t, Date: 8 b Location/Mailing Address: 76 13artis}aaol-e- y t-A e\ Contact Name/Phone: cell Soo-W,60 -2g3A Inventory Total Amount: ^'2 w� MSDS: 165 License#: 1fly Tier II : ND Labeling: t t Spill Plan: Oil/WaterSeparator: Floor Drains: !�C7 Emergency Numbers: Storage Areas/7anks: l'vvvl, 0 to W-%07 s yA AST Emergency/Containment Equipment: 4- S k OW 6 Waste Generator ID: MPS053b 024 Waste Product: 6>1 wu- -c! sIvoQ Date&Amount of Last Shipment/Frequency: '3 I'L$I I Co Licensed Waste Hauler&Destination: C�) O. 1 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 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/ - -le�j, fc0.v`1c cv{ , o.( O'�11n9k� '61- ew#L-}w Inspector" Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS `°fT►+E�okti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMA.Sq 8. 200 Main Street• Hyannis, MA 02601 iOlFOIMA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �,��.��i 7 Business Name: 'F<avt L%s e o's Avko f,-,A Date: - Location/Mailing Address: 7L e-s< 4-W,9. kk, Ati"Al-n. Contact Name/Phone: RAA(LISGb Go►L(:&*l e.ab S-cS-3&o-Aq3$ 13 7. �o Inventory Total mount: 2b 0 SDS: tO o�koo v License#: 1(94 (- Tier II : 0 Labeling: `N-t VVP4-e- Spill Plan: 4'0 u k Oil/WaterSeparator: ` Floor Drains:qe,6 Emergency Numbers: Storage Areas/Tanks: 2'15'�Q,1 ,A5`( — v%o v,v5.A- Emergency/Containment Equipment: !EW /aowe-1S Waste Generator ID: Waste Product: 0` y Date&Amount of Last Shipment/Frequency: Va k LQ.,,Q'2e.!c - a k .Ck loo 5.,t Licensed Waste Hauler&Destination: to t% 16 5 1 11 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 20, Engine and radiator flushes Bug and tar removers t Sst Hydraulic fluid (including brake fluid) ` Windshield wash y Motor oils (D Miscellaneous Corrosives ►o dal tor.1, - 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 7-03 XSs Printing ink ?•U Car waxes and polishes 15�4 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: Ak CtV0rA,%--1t-C6z \oAoe-Ile"I . %A ILI\ ORDERS: Ja. �.c r' INFORMA ION/RECOMMENDATIONS: Inspectors I • L �`�� ti Facility Representative:�� aoiA& ja,4 axe WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS \^\ Number Fee 1046 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Francisco's Auto Detailing 7iq 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 Town of Barnstable °FIME To Regulatory Services • °� Richard V. Scali,Director B"R ASS.`� ` Public Health Division s639. 9� �0� �F039 A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3;L7 P D-';9 DATE I S C90 1 S APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT r'(,a n-.c C y (-.n 'P. 66-n,c)e tf C 2c NAME OF ESTABLISHMENT R dIn ca co U-o D e ca i I n G • ADDRESS OF ESTABLISHMENT 3 'e Q,(-n S 4-tZb`f R00-j Ct n j`- MA TELEPHONE NUMBER �J���� 6 C� -- 02 7 .3 g C'>02601 SOLE OWNER: S NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL k PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK ' R�,�gi1.► A� �..Prtryl.�.Pn G�o.-�obi,"pc�/ . SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# C:\cache\Temporary Internet Files\0LKD3\1AZAPP ReQOH DOC °FIB►okti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMS�LE. ` 200 Main Street• Hyannis, MA 02601 039. �pTFOMP+A`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ir c ors a. , Date: Location/Mailing Address: 7I, 4<V-1 Contact Name/Phone: RkAc-t Se-o C.%& c ca o s-o8 -360-2438 eell -516-3ha-.7-438 Inventory Total mount: n ) MSDS: 4e-Z License#: I aqb C a l- Tier II : Labeling: _QK-+o�,4 Spill Plan: y�s Oil/WaterSer rator: ye-S Floor Drains: $ y Emergency Numbers: eS Storage Areas/7anks: a V- Go,o,ct—i.R- -P I ao - a.> Emergency/Containment Equipment: v` , 0--- V^fl ©(,JS Waste Generator ID: f Waste Product: fl��u SI���L�<ov►� b1�5 Date&Amount of Last Shipment/Frequency: ti- X e ltlatIAe ti Licensed Waste Hauler&Destination: Other Waste Dis osal ethods: V o t d'P�jDN.g•�jl.� of� n� v� 1�7 LIST OF TOXIC AND HAZARDO S 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 5� Other cleaning solvents&spot removers C--W%- Engine and radiator flushes Bug and tar removers Gleams C - Hydraulic fluid (including brake flui# Windshield wash 'L1 Motor oils 1,JGc fie- Apr( f^ � Miscellaneous Corrosives s-7e1 b-66eks 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 R,E� Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) SS Car wash detergents 0#4"^^' Printing ink Car waxes and polishes S,A-k Wood preservatives(creosote) Asphalt&roofing tar \ID1\ Swimming pool chlorine Paints, varnishes, stains, dyes i Lye or caustic soda Lacquer thinners Miscellaneous Combustible 5 I / Cav<S 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: ® aIV1,L m I u-• .� J Facility Representative: 04 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °Fro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B`",„��E. ' 200 Main Street• Hyannis, MA 02601 �OrFt639. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �raytGl$to's Date. 1� Location/Mailing Address: ?6 Yr�s-fa]ole } v4AV%t s Contact Name/Phone: V-cauc,sc.° Sob -3(00 -Z`f3$ ccll sbg-3(.0 -Z"8 Inventory Total Amount: 7 t� J MSDS: N o License#: t by So Tier II : o Labeling: yl a fr1 K Spill Plan: Il o Oil/WaterSeparator: Ye-,, Floor Drains: yeg Emergency Numbers: OK Storage Areas/7anks: a'l7�' allaw- �ksY- wrG{,_o%1 Emergency/Containment Equipment: kk 5 Waste Generator ID: MP�D95In0�'� < Waste Product: O•�y wakes! �Fcow�d•l/�1z0.5�� Date&Amount of Last Shipment/Frequency: 4-19.611q i 3 oS j&,J 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 grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) t75 Car wash detergents Printing ink Zo 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, 11\\ hydrochloric acid, other acids) N VIOLATIONS: o d bzs vy. grt2, �b S�P1\ A�avt po'A2k� ORDERS: &CA J�Sfl`5 town ASo0D\-410, t pA t- a\A 1&,o I e—-k c, e.OA e3 .5 M ati co PVl IN OR ATIO /RECOMMEN TIONS: &0A,4iM!g Inspector: LAC\l'�— Facility Representative:"'L P.1Mi11 P2� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS `°F� ►owl Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARMASSBLE.g' 200 Main Street• Hyannis, MA 02601 �p i639-6. DM TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE P'� Business Name: Date: —lr�'c�(� Location/Mailing ddress: Contact Name/Phone: kv�' S 6 66 Inventory Total Amount: MSDS: License#: r I Tier II : )V Labeling: Spill Plan: Oil/Water Separator: rg Floor Drains: N6 oN E Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: M V 56V `271 ~6Lft Waste Product: k2p - - rerz-C Date&Amount of Last Shipment/Frequency: --..d Licensed Waste Hauler&Destination: U Ies42- ,,, I Other Waste Disposal Methods: A[, ,a 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) G Windshield wash Motor oils 05 ),-s A-V-AJ 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)/batterie��:S� 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 —�L 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, l hydrochloric acid, other acids) VIOLATIONS: �G �e OJ �-frdi Je Ir 14 �) s -b S S Me -1' ORDERS: r'' -gyp 0 INFORMATION/RECOMMENDATIONS: Inspector:Cc., Facility Representative: i WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town of Barnstable �IHE TOwti Inspectional Services BARNSTABLE, * Public Health Division MASS. Thomas McKean Director 200 Main Street Hyannis, MA 02601 Phone:508-862-4644 Fax:508-790-6304 All Motors Auto Sales, Inc. Mr. Fernandez, 2/12/20 It was a pleasure to see you this morning.As we discussed I will supply you with things that need to be completed at your business. The forms I left you are just a guideline to use, on-line can give you more of a selection. 1. Please check with Town Clerks office and see if your business license is up to date. 2. Spill/and Contingency plan need to be posted,these should be easily viewed from work area. The blank sheets I left you show what needs to be on them.They also need to be reviewed by the fire department. Draw the plans up and show them to fire for their approval. 3. Waste oil/Anti-freeze waste needs to properly marked. Hazardous Waste,what it is and in contrasting color. 4. Waste oil drum must be capped off while not being used. 5. Speedy Dry should be readily assessable near the waste oil drum in case of spill. 6. Fire Extinguishers should have signage on the wall showing where they are located. Again on-line or your fire extinguisher supplier can furnish these. 7. You should try to obtain a metal cabinet with doors for storage of flammable liquids. So marked FLAMMABLE in contrasting colors, same as waste oil container. 8. The empty 55 gallon drum outside should be disposed of properly. 9. SDS sheets need to be available for employees, either in a notebook in office or in shop. SDS sheets should be for all liquids that you have in shop.Again,these can be supplied by the vendor or on-line. These are some of the important things that need to be completed, as agreed on you have 30 days to complete. I will be back to see final inspection on 3-10-20 AM. You have a clean and neat shop for your service work that is being done. Any questions or concerns, please contact me directly. Respectfully, C. Gus Johnson Hazardous Waste Inspector COOA)e Chester.iohnson@town.barnstable.ma.us 508-862-4645 r °f IKE Iok4 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RnRMATQq. .�' 200 Main Street• Hyannis, MA 02601 e,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT lED MP'� Business Name: 'All I04-4 s Acl Date: Location/Mailin Address- A(, 4rvl Slab(c Y�, h-A r 5 Contact Name/Phone: c��-1 L'al�� . Lv ti t-er 5 G2 11 7'714 Inventory Total Amount: ti� MSDS: by t- `� � License#: Tier II : n Labeling: \ ' -t Vvb-)('Z"5 Spill Plan: 0 K Oil/WaterSeparator: ►J ►2 Floor Drains: u Emergency Numbers: OK Storage Areas/Tanks: -� tNsw�.S- wah�-,c.- o. � �- k�.3-• lez�� o-�.<,�,,,,. 5 c. CP Emergency/Containment Equipment: S ovk 5,J%e, Waste Generator ID: 5 b'�77 1 .,t.n y Waste Product: r2( ( , wNk.V<e25a- J Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Oa ovL kp< 1 -e trJccSt-e�o< < . 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 S� Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluj (including brake fluid) Windshield wash Motor oils lb 5 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants �L 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) VI LATIONS&eVL f ka,%v-- .04w5 to At- 0, l (A 5 6110 . Scu+'ISY � ORDERS: do 0 h b �- 0 ,- VAIN.^ ,ti .e vL INFORMATION/ ECOMMENDATIONS: Q � -►� ,now t✓� vim. I..��O�-1 all co,� ��c�C Inspector: l..a Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS AID MOTORS AUTO SALsNEss :_...•��.---THANK YOU FOR YQUR BU .r • Z }�» \ 7RD, . GI qp. r EN mgs'm ,�\§»AJ%%'7 1\ §\\\ 260 -«»dmo&m6 @ 7m.mm . +@o/ a ^ Z© �wGaq-k2 . / . a , F� rok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 % BnRM..Bq $ 200 Main Street• Hyannis, MA 02601 A 1659.s�0 rfo TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: A I I IMv+6-rs Aul. &I.-_s Date: Location/Mailing Address: a+�n Contact Name/Phone: V,L 1 Lv,e, 69-11 ro°o—Z.o3l �`6� �``� 1 InventoryTotal Amount: ^ �0 4G�` v� q�� MSDS: v ������sh License 1 Tier II : ( Labelina: VJW4L+o W 4 wA5tP�o\k Spill Plan: O)< GC.Cuvw Oil/WaterSeparator: AJ A Floor Drains: o Emergency Numbers: �t l Storage AreaslTanks: o'e w .\ I- w ki0%k CAdv 0 .a'a.c. at ,L a• -r5. Emergency/Containment E ui ment: I r ava% I A.10 e�-V v-S 110, �� �c}� .,�s�s 'OVA- Waste Generator ID: MyToh'J� I�LoD Waste Product: o r' Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Self '-v-eg.h,Dor'+ b"k1 -I'o i2o,w+-4 D,xe-� — _ vg„4-11y �Qvtw-r—AV+& 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 9 cleanin fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid),,Z�Ikk Windshield wash Motor oils 55+554'-5 mukkoor5 � 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 y Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents okti1 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 reG Any other products with "poison labels" b/� nes 4-4o,�I n (including chloroform, formaldehyde, tn(t�u hydrochloric acid, other acids) / C/v t kP �r oC vk ✓ka►�i ✓ VIOLATIO o w�a v a Ii' I S ORDERS: ACC. 6 rs ci( Ov d -- -2 0 -CQ oil oc 0V a% s -4- ' � e�' �h 1 v INFORMATION/RECOMMENDATIONS: 1,6344—k Wk5Vt o t J , pow �,c.k-e v�y l 1n �acd�.v5 �n�k�r� 15 I1��►�- - Inspector: 7 �a Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS f Please print or type.(Form designed for use on elite(I21*ch)typewriter.) Form Approved.OMB No.205MOC UNIFORM HAZARDOUS 1` ro Number 2. 1 of 3 Bmr Resp�se Phone WASTE MANIFEST a? Rlt9f'. Jl 74Y 14 KS 5.'Generator's Name and Maifing Address Generators Site Addiess`(d d•AFerent than mTing address)'' GG Barnstable fi a �,YANN I S Mn'OK �:`F15t i Generators Phone: B Transportar l Company Name U.S.EPA ID Number aar`Ig: 'T�•_..p�t..E.f iV Na''r 3 T: :g TlI?� 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and,Site Address - U.S.EPA ID Number x3t 1T , RT. oa`30 Facility's Phone: 9b.U.S.DOT Description Includi P S' Name,Hazard Class,ID Number, 10.Containers 9a. (Including � �m9 11.Total 12 Unit 13.Waste Codes, HM and Paddng Group('rf any))-. No. Type' Quantity WtNol: '; tL�1� ����iy qq Q £.1�.ep�{... !! .: t�?p� (�)�y ,�g.}q ._ - 1 (Jchh3ppr4ryy.�t1-0 I,. (t'Il kjr.1l3ii#t4A.-�56 " 4^U Yg'y't iSP'f.�..C,. P'st 947 rL'�7 A'� . 0 (ND! US KIT I"if'ii'.t Ct i.Sfa.'s�r.1G`s MATE ER IY�{..) ,a, y W2. �a ' 3 9 _ 4 7. 14.Special Handling Instructions andAdditional,Information „j• tf lxCR- .. 69 7 4;tj�f (l( :r1 h z a i� m . a ll HR =�NERG .t'CY ; 4( 1 l� h l„t' �. EN) f , 1 4' tl !4 t t'i 4 15. GENERATOW&OFFEROR'S CERTIFICATION. I hereby dedate,that the contents of this.consignment are fully and accurately described above by,the,proper shipping naive a id are classified packaged; marked and latieledl ed'and are in all placard' respells in proper cortldan"far transport according to applic�e adematanal and.natioruaf gogernmerttal re{ptlahons ff expert shipment and tam the Primary Eiporter,I certify that-the contents of this consignment conform to the terms of the attached EPAAdcrxiwWjment ofConsent ft- I`ce ' that the waste minimization statement`identified in 40 CFR'262.27 a if l am a rhfy O( large Quantity geuieratoi)°or(b)('rfi am a'smali Quantity geateiator)is true. Generator slOfierors Printed/Typed Name Signature Morith Day Year - -! .�t* �, � , C'' aff,d i a u'3'�'•` �,tar / tx„;..�..,�?'t!,�"� �$• '::v'.:, 1,�- i;,l:c�a. 4 .: tj ,;,,+:+t ��r•,i' ,�, K,+•. '3 < ,I ., —t 16.International Shipments Import to U.S. 0 Expert from U.S. Port of enUylexit Transporter signature(far exports only): Date leaving U.S.: W' 17.Transporter7sdmtiwtedgrrt t'&Recaipt of Materials i Transporter I PnntWTyped Name Signature y Morttli Dapyr Year 0 CL Q Transporter Pdnta&Typed Name Signature Month Day Year. 18.Discrepancy 18a.Discrepancy indication Space ❑Residue ❑Partial Rejed- Full Rejection ❑ ovanbty ❑TYPe Manifest Reference Number: 18b.Aftemate Facility(or G�lerator). U.S.EPA ID Number ter. Facility's Phone: -' W'18c.'Signature'ofAlternateFacility(orGenerator) " Month Day Year Q Z 7771. N19.Hazardous Waste Report Management Method Codes(i.e.,codes for,hazardouus waste treatment,disposal,and recycling systems) LU 2. 20.Designated Facility Owner or Operator,Certification of receipt of hazardous materials covered by the manifest except as noted in item 18a Printedrryped Name Signature Month` Day Year EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COP �3�r� t, �4 LOU Sol �& S kb arnstable Barnstable ces Department PJAMWeaft I Division Q P iannis MA 02601 O D m 2007 Richard Scali,Director Thomas A.McKean,CHO tal Properties Town of Barnstable. All rental registrations expire is $90.00 per unit, plus.$25.00 for each additional 'hecks should be made payable to: Town of of the application form. Please print the ion, owner, owner representative or unit ce the unit number of each rental unit you are on. Mail the completed application form (s) along-- �� ���� � �` i Town of Barnstable Inspectional Services BARNSTABLE, : Public Health Division MASS. i6;q. ♦0 Thomas McKean,Director 200 Main Street Hyannis,MA 02601 Phone:508-862-4644 Fax:508-790-6304 All Motors.Auto Sales, Inc. Mr. Fernandez, - 2/12/20 It was a pleasure to see you this morning.As we discussed I will supply you with things that need to be completed at your business. The forms I left you are just a guideline to use, on-line can give you more of a selection. 1. Please check with Town Clerks office and see if your business license is up to date. 2. Spill/and Contingency plan need to be posted,these should be easily viewed from work area. The blank sheets I left you show what needs to be on them.They also need to be reviewed by the fire department. Draw the plans up and show them to fire for their approval. 3. Waste oil/Anti-freeze waste needs to properly marked. Hazardous Waste, what it is and in contrasting color. 4. Waste oil drum must be capped off while not being used. 5. Speedy Dry should be readily assessable near the waste oil drum in case of spill. 6. Fire Extinguishers should have signage on the wall showing where they are located. Again on-line or your fire extinguisher supplier can furnish these. 7. You should try to obtain a metal cabinet with doors for storage of flammable liquids.So marked FLAMMABLE in contrasting colors, same as waste oil container. 8. The empty 55 gallon drum outside should be disposed of properly. 9. SIDS sheets need to be available for employees, either in a notebook in office or in shop.SDS sheets should be for all liquids that you have in shop.Again,these can be supplied by the vendor or on-line. These are some of the important things that need to be completed, as agreed on you have 30 days to complete. I will be back to see final inspection on 3-10-20 AM. You have a clean and neat shop for your service work that is being done. Any questions or concerns, please contact me directly. Respectfully, C. Gus Jo nson Hazardous pector Chester.iohnson@town.barnstable.ma.us 508-862-4645 S '_ „'§" ml�'w`"�M_....,_ ..r. ..,e.'"R..+�!'�-+r—Y.{�"5 r�'r'!"."''. :...._�."r�.i.,-.4"-�,.�..�.�.'• e.Au '� tom; $ ,c TOWN .OF BARNSTABLE �—I• -Ordinance or. Regulation ` WARNING "NOTICE Name of ,Offender/Manager Address; of Offender MV/MB Reg.# Village/State/Zip . Business Name . 4 i r 4n, � ,.am/pm, on / ! 20 11 Business Address Signature 'df Enforcing Officer Village/State/Zip `1 �''+'f r �..f" � ,n I F Location of Offense 111.t4Y44A Enforcing Dept/Division Offense 3 '�t<� -:f ,:> .E `-, '�,- "! r i �i _._ r� �� d ra Facts jt"Fl This will .serye only f a§ ,a warning. `At this time no legal action has been taken.ri It is the goal ;.;"of Town. ..agenci:es to` achieve voluntary compliance of ,Town. Ordinances,' `Rules, and Regulations. Education efforts . and warning notices:N.,arei•, attempts to.: gain'- voluntary compliance: Subsequent violations will result in' appropriate legal action --by the "Town. k� WHITE OFFENDER CANARY ORD:/REG PROG PINK ENFORCING OFFICER! GOLD ,ENFORCING DEPyT ,,'w'.+WcxvE �., n TOWN OF BARNSTABLE BAR—W 10 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on !/ 20 ' Business Address .r �-- Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense Facts r 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. nWE►owe Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARM SABLE, • 200 Main Street• Hyannis, MA 02601 39. iAN'�°`e� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: A-0 Ma' tet, &t - �kys Date: 9 I y Location/Mailing Address: Ltr j&,AAtf Contact Name/Phone: %LN D e C,alle , Lvt a, Inventory Total Amount: C t Al MSDS: �o License#: Tier II : 00 Labeling: b�& Spill Plan: Oil/WaterSeparator: — Floor Drains: No Emergency Numbers: Storage Areas/Tanks: O owL- Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: w s},e. v\ b k a \Vt ac.2 0 c 4-V u500-11 �A�- 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. Z 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 -- i e70 wo-6fie c,,1 cry Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants iD 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: Oo-1 tool s+L>-� DX a✓vu-I- Aoit` -vu+ 6or1}a1vc0RVT�- ORDERS: &4-e_ 411 COV4 t,o.er'S 1 s Aa -71fra4� — C b io I liq INFORMATION/RECOMMENDATIONS: o ca 6Lv1 5L��k InclL �ag vr�a�.+x��cbl�. 1 Inspector: Facility Representative: e� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS II� - .. i -� "' �'�,Z'�+,Yu�, TOWN OF BARNSTABLE RnR FfN 4u "r}yC �ka$s k -• 'u ; ..•e✓ `srr a \,lw , BAR-7*W G;w.K 6J ; , � a� ' Y� xOrdinance or. RegulationNR ,,. s WARNING NOTICE hs r Name ;of Offender/.Nana er, ;;3±V e ,.,,r t ,.•`.. ' Address of Offender MV/MB Reg. Village/State./Zip. � 2, :20 Business Name - � r��v��.,r� .�+�';ir.�:> .���. � . . � "� am/ m< on `� ,,�' t 3 ' r Business Addrefssir ? +� �� � r µ`' Signature .Qf E'nforcg: Officer ` " 'df . 1' ✓ y .x :a 4 r d � .: ..r �- Ii.k'`9t��I5�`,+M. r Village/State/Zip " +n,'W1 , ' t Location of Offense �; ; to ;. } Y r ; l,js,V,41 S Enforcing ;Dep.t/Division Offense V4 :�ti o :K4yt5 �`� 1,. rv "vs 1 - 4 �v� r'aHac f� ;.� � a Facts' �'-�1k- r , «��J � ;;�+,� '+;a 4 �t../ ff� aF �f r'ti'1 � it,. Cr C o t�r i i'�fel a 4_01 t �h.c chic '..v ' Gic lfj a��'1+' �C�A�`�.o This xwilit~:serve only .as a warning At ,this time no` legal' action has beery taken It is3 the goal of Town agencmies to achieve votuntaiy compliance „ off Town Ord nances, Rules{y and Regulations3 `;Education efforts`'and warning" notcesare'� a-K^ attempts to gain voluntary ,compliance Subsequent violations will zesult�` in appropriate legala_ction by the 'Town. �i a FORCING .ENFORCING DEPT.`-rGOLD'=ER OFFIC k - x w, `WHITE, OFFENDER CANARY .ORD'/REGr=PROG-YPINK-EN TOWN OF BARNSTABLE BAR_w >i52 Ordinance or Regulation ' y WARNING NOTICE Name of Offender/Manager ,#, Address of Offender MV/MB Reg.# Village/State/Zip Business Name ' `'' - r , A. # , t . ' ' am/pm, on =e` 20 Business Address <r >� •�,,�:� §�:� .� �_!� < � ,. Signature .of Enforcing Officer Village/State/Zip 0,1 tAio a _`2 , (- � } 1�, Location of Offense r Enforcing Dept/Division Offense t;'t t r t r `�r 1.; 1 ,� t � 3d t ' # a j"-- r . Facts '.s )1 �1 This will serve only as a warning. At thistime 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. i Date: ( / y / 1 3 TOWN OF BARNSTABLE I vt� ,o+�. TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: A Ao}o BUSINESS LOCATION: Cro �n.5 ��+R� , {-��a�,n ,S INVENTORY MAILING ADDRESS: SQwtR— TOTAL AMOUNT: TELEPHONE NUMBER: So'6 -7? 1 -is to 0 0 --- / 'L CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NU BER: MSDS ON SITE? TYPE OF BUSINESS: AJo INFORMATION / RECOMMENDATIONS: �) ,�, V4 Z, us ,,,,► - c,a 4— Fire District: ,II Coat, ..e-y e. q.le.Q ,,a, .ccx q�/ahrti5 mJ A, 4-1e, 0%>W200 c , of T q � T o w v o4e< Uf,e 41� v►.Jy�C6w-kl,v.eP� �JoJA< wagh, „J,4-h. 3 It, Waste Iransporta on: Last shipment of hazardous waste: 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 1.5� Motor Oils Pesticides NEW I`I ® USED3mA5r Y-tGO (insecticides, herbicides, rodenticides) XS-fal Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) 3 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 3 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 Lt�llv.>Vj av,91Z4113 1- -1 anl.0 J0w4e!Z v✓�-.H Laundry soil &stain removers (including bleach) r�w"V4 , a-m jtj . I/J•r�S�,<< Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents p Bug and tar removers bt���� �a�11-f o4,0\);Mci-/1.h _ -WA ' o Windshield wash �o„�� de cos�5 .�rtVlzy(�er�✓toW .0 II1 q a(t&" WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials a 7186 8x 0.4,P* Form Approved.OMB No.-2050-OM Please print or tape.(Form desk_W for use on elite(12-pilch)typewfiter.),t..� UNIFORM HAzARDoiii.: I.:G&-NaWID,Nikrtbor .-,,9- 2.Page I of 3. - 1 WASTE MANIFEST 7 07 � 5.C K. "z Aiivii v,%AA US-FFAR.Number 6.'Trans rter I Cm NameP.w:— 3AFVY—KLtE,X S Y 6 f ErAI 1 W7, 7.Transporter 2 Company Name U.&.MID Nurfiw B.Desk atedFacftAan!e�qr0,SbMdr8s�-1i,, U.S.EPA ID Number jn, "FETY 'N'15 M�1151 i 09:1,TP -"KLFE -VIS J Fa. (s Phone: 9.. 9b.U.S.DOT Description(mckiding Proper Shrppeag Name.Hamad Cass,ID, 10.Cadakm 11.Total 12 Unit 13.Waste Codes i ' HM and Padft Group Cd,ap� ypsm-.,m a MW Ix q0(Nor 1111SOof HAZARDOW. ft1ATERXALYf.-.1�-1 LU 2. Q 3. 4. v 1 t Special id�4 24 EEN) 1-k Hngrl�m 10 kvt N I T 11 1-6, at*-4 1 c,g,R R I V--fa,as, M' "L'F-ty-guv, )FFER0R'S,CERTW1CATIDN:.I hereb y w fulyand ccuratelydescr"09vp ." uW 1�.,, GENERATOR a by proper b appl ir� nmert Im madceaf and p�c and are In al respects co0twq, port a"rdmg I _W gulallons.If wmort ftment and I am the Pnmary and,nationalVm_F!p "Exporter,I certify#iatftc'&19'ei&'4 Bus-croristgavrrent'66k"116"the iimi of the i6 EPA�,a�i ' '" '``;,I cetBFj'tliat'the waste minmiiiatlon statement iderr8fied'm 40CFR 282.27(a)(if'1'a'm'a large quantity geneiatii�or(b)('rf►am asmaft Y tS - Generator'Iftroes Pdr6dffyped Na Day Y, ij -1 16.International SWVwts t n try El Import to U.S. 0E)Wfrom dSi' K Transporter signature(for exports only): Date kkift U.S.: it 'dR Uj Tainsporter,l PnntedlTypedNarrre Signature iNonga s Day Year 0 U) Transporter.2frk9affypedName `: S Oay Year,,' 18.Discrepancy 18a;�DscreOndy ln6icatioi RelerAeonL-J Fug fteJecWn_ Residua f7 Manifest Reference Number. 18b.Aftemate Facility(or Germatpr),, U.S-EPA ID Number Facilq:A`Phone .-.,- 18d Si§ hnaturebfAlternata Facility(or GefteiaW)' Month Day Yedr' 19.Hazard6m Waste Report Managemeid Method Codes(i.e.,codes for hazffddus'*asWV6aliment disposal,q#,rw—Ift system), 3 U.1 2, 3. 120.Designated Facility Owner or Operator Certification of receipt of hazardous materials covered by Q* pxoa�, nado, Item 16i" 5rgr�ae Mom? ty Name EPA Form 8700-22(Rev.3-05) Previous edftm are obsolete. GENERATOR'S INITIAL COPY Date:B /-�7/ /3 TOWN OF BARNSTABLEf �yt 'o►� TOXIC AND HAZARDOUS MATERIALS R N FORM NAME OF BUSINESS: A*,rs Av& a es BUSINESS LOCATION: to S ah le- tqX, WvLvi YiL5 INVENTORY MAILING ADDRESS: --kotL- TOTAL AMOUNT- TELEPHONE NUMBER: SOg - 771 - b ( 0 U _ -7?1-gee-bedot�3 CONTACT PERSON: Vie-for C&III So8-3%- yw -1 LUI�I f-ec-tari..e-e: EMERGENCY CONTACT TELEPHONE NUMBER: y-36 8 -.Za31 MS�DS�QN SITE? TYPE OF BUSINESS: 4i -5 t eV1416e 4W r �(lo INFORMATION / RECOMMENDATIONS: Ot"t v,0 0vf� fsf��a Fire District: lAyt^_. ' / c+vl✓1 r5 T OJ 00,(- 3-TO 0&1 046+f a r 1/A��a r- 66f4e IE ft5� s 014-i ►L 6k"+ e,1) L 4 e, &I I Ae-e r' o -I-arwers 9/vo VehIe-le- mo4shI 1r,�,Waste 5O&V rs aI1owe rhow..� 01,c jr) 6ltcw II*ras1— -t t, res �Cle4,L,rns,�g 4 Waste Tra sportation: ks� e�i I - �m ast shi ment of hazard us waste: 2AoQ&V vvtc� w a 5+ 3 y6a r . Name of Hauler: Destination: vs 45+e Waste Product: vs � �� Licensed e o MJo$771 �b0 cue 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 uv�n=3-o��40 �a,S�.3-sedQ The Board of Health and the Public Health Division have determined that'the following products exhibit toxic or T 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 (USED330 Pesticides ❑ NEW 0 «�; 5 (insecticides, herbicides, rodenticides) cv y 1 Photochemicals Fixers Gasoline, Jet fuel,Aviation gas (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) Glean,oy ry bdec"p— Spot removers&cleaning fluids (dry cleaners) e, r A Co I {- Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials ` Date: TOWN OF BARNSTABLE— /o,,� TOXIC AND HAZARDOUS MATERIALS N FORM � Q I NAME OF BUSINESS: +' c sco s /JJTo �� �, BUSINESS LOCATION: -76 14*ahv11s INVENTORY MAILING ADDRESS: .SetM-t.r TOTAL AMOUNT: TELEPHONE NUMBER: SDg 3GO - 2-43A .21.E CONTACT PERSON: ��a rice sco CoylG�./GQ D EMERGENCY CONTACT TELEPHONE NUMBER: 5-0 5 36 0-2,g3S MSDS ON SITE? TYPE OF BUSINESS: A Ao -De-4-4-1, ye S INFORMATION / RECOMMENDATIONS e, Fire District: OOK4,L 6, �44 Ave s Cr" + Do-y Co e- HyvMVtIs a►n ¢z + " IQa �o r So e x vt I — �,4 A- co.�a�t�,Q , �a. l le l ogc- r-0tit-�a,we.�s r� e v�_yl�"/n us ems. Waste Transportation: '. // s{,���,�'iar►uwcbtes ��.M.c..f-a.1 gab��- p N�� Last shipment of hazardous waste: 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) 1( Miscellaneous Corrosive 2 NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes aQ b Road salts(Halite) Hydraulic fluid (including brake fluid) Refrigerants I or Oils Pesticides ANEW ❑ 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 s Miscellaneous Combustible (, Car wash detergents Leather dyes 10 Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's J Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 5- Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) �p 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 1 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initialss TL— Town of Barnstable oF'THE A Regulatory Services '4o Thomas F. Geiler,Director Public Health Division * snuvsTnst.E, Thomas McKean,Director 9� �9; ,�� 200 Main Street, Hyannis, MA 02601 Phone: 508-862-4644 Email: health@town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 April 29, 2013 Mr. Francisco Conceicao RE: Hazardous Materials Inspection Francisco's Auto Detailing 76 Barnstable Rd Hyannis, MA 02601 Dear Mr. Conceicao: I Thank you for your time and cooperation during the hazardous materials inspection at Francisco's Auto Detailing on April 18,2013. This letter contains information from the inspection that will help you become and remain compliant with the Town of Barnstable Ordinance, Chapter 108, Hazardous Materials. The inspection was a review of your facility's storage,transport, utilization and/or disposal of toxic and hazardous materials as it relates to the ordinance. The inspection inventory shows that the facility is using and/or storing approximately 215 gallons of toxic and hazardous materials. The Board of Health has determined that using, storing, generating and/or disposing of over 111 gallons of hazardous materials requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. You are required to purchase this license from the Town of Barnstable Town Offices,200 Main Street,Hyannis,MA 02601. You were provided with a license application at the end of the inspection. Please note the problems and the recommendations or orders identified at your place of business during the hazardous materials inspection: materials inspection: PROBLEM: • No Hazardous Materials Permit for fiscal year 2012-2013. ORDER: • Obtain a Hazardous Materials Permit for the fiscal year 2012-2013 from the Town of Barnstable. An application has been provided to you. PROBLEM: • No spill contingency plan on site. ORDER: v • Develop a contingency plan in accordance with Town of Barnstable Code Chapter 108-6. A contingency plan outline is included for your use. PROBLEM: • No spill kit on site. ORDER: • Obtain and keep on site absorbent materials for use in controlling and collecting_ any accidental hazardous material spills. OTHER RECOMMENDATIONS: • Close all bottle/buckets when not in use to prevent accidental spills. • Used rags contaminated with solvents/thinners should be stored in covered, metal bins. • Store all flammables in the metal flammables cabinet. • Some"good housekeeping"could reduce the clutter and ordering less product more frequently could alsc reduce the amount of hazardous materials counted in the facility's inventory. This information is intended to educate you, a business owner/operator in the Town of Barnstable, in order to keep your business operations in compliance with local, state and federal toxic and hazardous materials laws so that you can avoid future regulatory problems. Complying with the Town Hazardous Materials Ordinance, can prevent contamination of Barnstable's existing and future drinking water supply, prevent environmental contamination which can bankrupt site owners, lower cr destroy land values, drive out residents and industry, depress local economies and endanger pubic health. If you have any questions about these observations or you need further information, guidance or assistance, please do not hesitate to contact the Public Health Division. Sincerely Timothy I avelle Hazardous Materials Specialist All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials shall be completed upon receipt of this letter. Number Fee 1046 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Franciscos Auto Detailing 76 BARNSTABLE 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 06/30/2017 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 a— Director of Public Health -J 6 s. Town of Barnstable 1 �t Regulatory Services ° Richard V. Scali, Director BARN ^c.. ` ASS. E M ` Public Health Division BARNSTABLE "'" a639. ,0� �`was o'x"s Taus' nu m'w"reN nsin6 CFO MPS Thomas McKean Director 1679-2019 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 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 V• 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. DATE �fio FULL NAME OF APPLICANT: F7P'Pw C-i•S C--;' P C R C-4 R(-) CON C 6'; CIAO FZ l` ' F E TABLISHME T: � �N G S � 1•NAME O S N Ck7 S CJ�F-o -e a»G;_ ADDRESS OF ESTABLISHMENT: a6 (3 cuvns4x�.,bi e. H ua.rn� MA- MAILING ADDRESS (IF DIFFERENT): l TELEPHONE NUMBER OF.ESTABLISHMENT: (�L-Q J 3 4 O VNLkIL ADDRESS: SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF APPLICANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 I l T Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 . ent3tnat Public Health Division Thomas A.McKean,CHO ar a` 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $125.00 (Check) on 6/8/2016 Permit number: 1046 [Check number: 2493 Check amount: $125.00 . Name on check: Francisco-P. Conceicao DBA Francisco's Auto Repair (Business: Francisco's Auto Detailing Owner: SUSAN W&CCBT TRS 'Address: 76 BARNSTABLE ROAD, Hyannis I t I i- — - ------ --- ----— .. - _...—. -.... .....-— - - --— Number Fee 1046 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Francisco's Auto Detailing 76 BARNSTABLE ROAD, Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------- ------------------------------------------------------------------------------------------ ------------------------------------------------------------------- --------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health ;c Town of Barnstable Barnstable �'WE Regulatory Services Department All-AmatoCity Public Health Division 9KASS. 200 Main Street, Hyannis MA 02601 039. Fe s 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT R /I/L 1.5 P D P C (),41 M 7g,4 d NAME OF ESTABLISHMENT r1 A Nei.S&os. A to ToJRL'AI g may) �1 L I A'-Y ADDRESS OF ESTABLISHMENT�Y19 6 A Al2M1, 2d R U ftq&Alj-,� &ej 06 1 TELEPHONE NUMBER_0:8 3 6 SOLE OWNER:XYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK ia.►�J n Ljmj eyInio SIGNATURE OF APPLICANT ' RESTRICTIONS: HOME ADDRESS �3j 3rA '),V-? R1,&K 8 VA"lj HOME TELEPHONE# E 09 3 6 0 9. !J 3 J:\inspection handouts\Haz Mat Application2008.DOC MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow time for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition, please mail the required fee of$100. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Paize JAinspection handouts\Haz Mat Application2008.DOC I a.N SPILL CONTINGENCY PLAN Emergency Coordinator, Name: r.R,ANL 152() &f Alg t &Ap Address: �b 13,A /1/j TA R L�' ZD 11 U.i a liS M.A a- ® Daytime Phone: S D S - 6 D n Evening Phone: 5® A3 d A 21 33 Fire Department: Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: eel v; C0 C-7, Phone: a W- Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. TOWN OF BARNSTABLE BAR-w 4 24 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager o'r�4 1e .: , Address of Offender MV/MB Reg.# Village/State/Zip Business Name A J i 4 �o i a d v Q ,,aamm7.pm.,.. on � '` 20 / f Business Address '07(101 Signature ." Enforcing Officer Village/State/Zip Location of Offense -74 1r ("o4nWe oa • Pea �-1 k ,F� } { Enforcing Dept/Division f Offense -�'w + fu(� �o �r�i"�'t3rtK 1':G Lt fdCr7t ►° t�/�'{rA IS Iyer`A 1 -ircr)r'AAyV'P 1 ) n,S+�i.61"9- Facts '. }. ,' , ��et /f� _. !�t✓5 � non .l r 7 t ►/S. 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 BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager + Address of Offender MV/MB Reg.# Village/State/Zip Business Name f ' I ; !1• .am/pm, on i`.�% 20 f., Business Address / , I ""a :l Signature .of" Enforcing Officer 3 Village/State/Zip ') X Location of Offense Enforcing Dept/Division Offense �. v - r4 r e'.�_: r, �: ..- : ,: .� � I- L;+� Facts 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.