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Home My WebLink About0100 BARNSTABLE ROAD - HAZMAT /00 _ 471 a7/ _ tom Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod .....----------------------------------•----.....--------•------•--•--•--------•--••-------... 100 Barnstable Road, Hyannis, MA .---•-•---•--••------------••••---•••••.............••------••--•-...--------••-------•--•--------••----.....-----•---•---•--•••----•••---•-•-------••---••-•-•-•-----•- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ---------------------------••-•-----------...--------.....------....-------•--•-------------------••-----------------------•••---------••--••-•-••---- Restrictions: --------------------------------•-•-----------. •---------•-•---------...--•------...-•--•••--•-••--••...-----•----•----••-•---------••--•-•.........---•••-•-•-••.. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 'b Town Of Bamstable • Inspectional Service''s ,.A Public, Health Division i 'Thomas McKean,Director 200 &in Stzeet,Hyaanis,'I A 0=1 C:' .p, Frye O�: 5U8-862-4644 n` ��p �}/�t=/�p 1. .- .. .... r17s JV0��7V�i7.7LY! i l APPLI ATION FOR PEPMT TO 1STORE AM/-OR U11LIM � `:HAZARD{DU I�ATPRIALS IN ACCORDANCE WITH THE.TOWN QE BARN STABLEGEN� UOINAACE,.CHAPTEP.J69 BAZARDOUSMA U§ms ;STHATH OR STORE I3AZARbOU' S MATERa L41S GREATER lliN HOUSAHOLD QUANTITIES.,AM REQUiRE17 T4 OBTAIN A3+i AATii3AL.PERMIT_(RUAtS JULY i st-JUNE 30th)., APPLJCATION FEES CATEGORY 1 PERAUT 26 11t1 Gallons,,, � 50.�0 CAT IEGORY2 PERMT 111 409;�1ons. $125.(Dfl CATEGOvsr RY 3 'ERAII3' S(# �r rnoie taallszs; 15fl.�4 *A late ch a of S�ll.fllD will be ass ed if"iavment is MOA Teem cl by 3u1v.Tst. 1, ASSESSOR'S IMP AND PAR P14; . 2: IS'I'13IS A PERK RENEWAL?. S NO, IF'YES,SK[P QUEST ON 3. I FOR ALL NEW PERMIT APPLICATIONS,E%TJCATE WHETHER BUSINESS HAS Z0IWM_dT13l<F1IlM1NG APPRL)YALFCI3tHAZ" L33i3S i ST4BAGTe }S�OIL GREATEIsL TBAPI�UUSE 3 1I,D(UAI'+IT'1 .(25 YES,_ NO1 • 4. FULL NAW.OF APPLICANT: ArM��rtfia Haa =:1C,t±c-_ S. NAKE OF EST'ABLI NT . L 904 0Z CAFE,ja4 b. Abb'RESs O-F�sT."Lis 7. MAMING.ADDI (IF'.DIFFERENT FROM ABOVI ;, a. PHONE IN OF ESTA�LI D% 9. 'EMAILL ADDRESS: A CKSD tj ce� -DVIXy 9 a 10. SQLEDwi > : ✓ xis__No IF M.-NAME,E OF PARTNER: 11. FULL NAME,ROME AI)3DRES$ AND TELEP19QNE#OF; CORPORATION NAME. AMR AuLQ Ho di - P1 S)E ' Todd R. Skelton Chief Executive Qfficer Wesle Pandoff-Chief Financial OfFic r TItEASU1RlER Y CLERK Joseph Girardat-Chief Legat Counsel 12, IF PRE-PARED BY f1UTSIDE PARTY: NAMVIE TELEPHONE#; CiD IPA J1'ADDRESS EMAIL, 6/24/2020 SI�GNATURZ.OF APPLICANT S'% i DATE • QsiF�}splis�Sion�pmiCstHaz Mat Ap}�T I}reft 3s�2419.dc+cx Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis, AM Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ----------------------------------------------------------------------------------- - ------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. -------------------- ---------- -- PAUL J.CANNIFF, D.M.D,CHAIRMAN _D_ON_ALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health f Town of Barnstable Inspectional Services Public Health Division aBA� ISTAB E ,ram M+1RNSfi!f Nll:i•g5'f4YiLLG•xrv'6iin'>TMSitf 1639-2014 9 BAMWABM " Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 ►w 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 ❑ (?a(�l4w CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ 4— 3NO6(0s 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. 1-06 ;_ea-_4_w_j y d, 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: _LQ/1�61 5. NAME OF ESTABLISHMENT: 4 n4f �" &61 014—, e 6. ADDRESS OF ESTABLISHMENT: �ey �� 4a4tor,6O, )W GW,01 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ,L 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 PREPA D BY OUTSIDE PARTY: NAME G� TELEPHONE#: --4/��-� � COMPANY A16DRISS. EMAIL: 1�*SIGNA OF APPLICA��'/IiSl Ml- DATE C:\U ers\ ohns \A Da a\L al\Microsoft ndows\Temporary Intemet Fi1es\Content.1E5\0BMJMR94\Haz Mat App Revised 09-10-18.docx MAIL-IN REQUESTS { Please mail the completed application form to the address below. In addition, please include the required fee. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. In addition, please mail the required fee amount. 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 C:\Users\jjohnson\AppData\Local\Microsoft\Windows\Temporary Internet Fi1es\Content.1E5\0BMJMR94\Haz Mat App Revised 09-10-18.docx fig a�Barn;srtab�e r PbbiltRealth p�Gtor�al.5er9c�es: . 4 fon .f _ 'Thom McKean;D-Ireotor t 200 lV sk.S et,Hyy8112315, 26d'1 -__.: __._. ___..._ ...._....._ .............. ...... _ 1 Office 08...86�4444 Fa�c .508-79¢6%4 APIsI� AT ON.FOR PIlOM"TO;fiTO�:A]Yl��EI�R UTTL•ICE 19[��ARI�OT�l !►�5. Infi 4t;GORDANCE i�ifii THE T 4F BA STEABI;E MAL QRDi 4AHC8 CRAFTER 1080 HAZXWdW MATE?JAIg ALL BU. STORE HA�MATERIALS GRAxFR TldAN .L'SE130LD QIJAtT6S-ARC RET7ED Tfl mBT _t1N:AIJI�fiL�BLt1u1IT(T�[?1S a[TL�'':1st-'7CJNB3Ofh). . AO S S g&TECORY I PE1�1'IIT_ 26-110 Gallows; SA 00 Cl CATI✓ l '4 2.PElt 1 IT' 11 I 4 Gallons- 112500 CA. CfltR '3 PI�RIVIIT so-orMDre Gallun�: $.I Q00 -vsr *A late charge oa1QAtl l)c.assessetl if payrtxeiftJi notiecedved:by h 9t 1.. AS' ESO '51 AlA7? ly%;. 37 OS 2. TS lim.A YERAff RENEWAV,Z' �_NO. w YTS;mp( p"MX:3:. 3., OA.ALL<Xg-W.:l'E1 �3'P�,r�� Qi1S,lAfllICt�TE"G��E3'NERBfJSItFFF.SS HAS ZON KG/RUTLDING AOR:OVa 1�'�QIZ�H� QUS MAT�TALS STORAGEMSE OF GREATER THAN 110-ISESQLD-QUANTITIES(25 GAT� 4, ice;NANA,.OF.ApPUCANT4 Da l d Rb5e.�be �11fA 'QF fiu L LAi }�o�e -, Ct�Oe L'o d 5, ann> ss o a r my r r: 160 . $a V v sf,hU Rom rYlA . MAarx Av�o SS OWDUM RE rr s: EMAZL ADD$ESS: _ s m 4ICd K�►,re ,�•�. o�.�.. so.:SOLEowIR� No:x> NO;,1�TAl4IT'off YARN. D:. FH U*-(.I�-).":i 190M-APDRES5,AND PRESIDENT Dawid 'KoSe'n beg nw- Asummm'. . N a- �C1ERI� 1Z:l'PIdPAREDr AYOUTSM;PACTY. iV: ME TELEPI ONE: :, e0�'d;1�T�•,ADDRESS - EM'A:IIs: :S:IG- QFYAT'P ;ICANT. MAT Q;\App11ra5onFaatas�i] Itdet AjiRtEvt�etl_09,IA;78:8oiae Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------- ---------------------------- ----------- ------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health i ' enof Barnstable g atory ervices �d f Richard V. Scah,Director : Public Health Division $AST , ; blpYmF? S4f Ui6!XiR21 HkY.riC W Thomas McKean, ec Dirtor 90) �a 203 Main Street,Hyannis,MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 C 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 XVIS *A late charge of$10.00.will be assessed ifpayngent %s z�ot_r" oei�j by July 1s> 1. ASSESSOR'S MAP AND PARCEL NO. 3271056 2. IS THIS A PERMIT RENEWAL? YES x 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)?x YES NO. 4. FULL NAME OF APPLICANT: David Rosenberg,Manager,_AMR Auto Holdings-LC, LLC 5. NAME OF ESTABLISHMENT: Land Rover Cape Cod 6. ADDRESS OF ESTABLISHMENT: . _1.00 Barnstable Road,Hyannis MA 02601 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: _ 8. TELEPHONE NUMBER OF ESTABLISHMENT: 888.522.1021 9. EMAIL ADDRESS: david@driveprime.com.. 10. SOLEOWNER:xYES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Land_Rnver_Cape Cod PRESIDENT David Rosenber TREASURER CLERK _ 12. IF PREPARED BY OUTSIDE PARTY: NAME: _ _ TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATEE(n 1 I I I Q:1Application Forms\HAZMAT APP 2017 REVISED. ocx JulN 20 2017 PM12:14 Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis, MA Is Hereby Granted a License For: Storing or. Handling 500 gallons or more of Hazardous Materials. ----------------- ------------------------------------------------------------------------------------------------------L------------------------------------------------------------- --------------------------------------------------------------------------------------------- ---------------------------------------------------------------------- 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 W- Cl1K�# 6760 2y J owr of Unstable eg atoervices oFt ram, Richard V. Scali,Director � • o Public Health Division BARNSTABLE �= � {.RYSfAOIE•i.ENiER"ILLE•CtlNR•HYMt:15 � IAMMAELE• Thomas McKean Director """"'"''S" • ``"" •"'_`" MASS. A ) 1639-2014 Arco59. .�6. 200 Main Street, Hyannis,MA 02601 �g 0 Office: 508-862-4644 o�01-7-4,016 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-NNE 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 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. fI��5C1� CQ 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: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: of'rl f)h A , le 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 55 9. EMAIL ADDRESS: 10. SOLEOWNER: YES_ANO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME L LC. PRESIDENT `-rl rrrm S S' G TREASURER J CLERK _ 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: gLAS • COMPANY ADDRESS A I EMAIL: SIGNATURE OF APPLICANT DATE 12 QAApplication Fonns\RAZMAT APP 2017 REVISE4ocx U' V Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 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 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 Regulatory Services Richard V. Scali,Director ` BARONMUBME. Public Health Division Thomas McKean,Director . 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.0.0 ASSESSORS MAP AND PARCEL NO. '� DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN i l i GALLONS OF HAZARDOUS A RDOUS MATERIALS FULL NAME OF APPLICANT ��P� Ay74 (: Cw Ll C NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT /&*' td— ` TELEPHONE NUMBER -re /7 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: J0,Qy26_1,L9_ 93 fio_)eESs' APT kdgXr®N MN 0,R34y 6'�iel�ss, r. . 3�1G8q IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Fo/&,-rY Xr 1046Ed.4 /yIA HOME TELEPHONE# 7 - SAS- V27 Mcache\Temporary Imemet Files\0LKD3113AZAPP Rev2015.DOC r Town of Barnstable Office: 508-862-46 44 y� r ,- Regulatory Services Department Fax: 508-790-6304 if nnRraS Public Health Division MASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: $100.00 (Check) on 6/30/2015 Permit number: 401 f Check number: 49009 Check amount: $100.00 Name on check: Range Rover ! ;Business: Land Rover Cape Cod !Address: 100 BARNSTABLE ROAD, Hyannis I i a • • Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 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 i Town of Barnstable Regulatory Services Richard V. Scali, Director Y Y 9'MASS. Public Health Division i639• ArF MAC Thomas McKean, Director . 200 Main.Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE ��/� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Capf. AwTo �R�p LLC NAME OF ESTABLISHMENT U ti l&1ut We cob ADDRESS OF ESTABLISHMENTn 1�. EtR�►1dT(i�LE 1Q D. Wy,n�IrJl t TELEPHONE NUMBER n f- 77P• 004q SOLE OWNER: YES X NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS.OF ALL PARTNERS: -�, &F.", a 3 naitcs, T Jin ►A&S Ud MA b;13&q �rrmes AmEtt Dios KfTco CT. T4jeP�! SoginlexI FL. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS .73 Fo&csr Jr. K146-StP4. 10 HOME TELEPHONE Q:Wpplication Forms\HAZAPP.DOC I A SPILL CONTINGENCY PLAN For any spill that is 25+gallons, the following plan shall be implemented and proper records of action shall be kept on-site: 1. Evacuate the area if necessary. 2. Shut off valves, pumps, and electrical items as appropriate. 3. Remove or restrict any potential ignition source from the area if the material is flammable. 4. Cover or dike all sumps and storm drains. 5. Contain the spill by using absorbent pads and material (or additional absorbent pads); contact spill response firms if necessary to assist in these activities; notify the proper agencies as appropriate. D.E.P. 24-Hour Spill Hotline............1-888-304-1133 Clean Harbors ..................................1-800-645-8265 Fire & Police...........:..........................................9-1-1 6. Remove all absorbed material or contained liquid and package it in a D.O.T.- approved container. Used absorbent material should be packaged separately from liquids. i 7. Label all containers with the type of waste and start date of collection. 8. Once the spill has been controlled and materials collected, inspect the area for cleanliness and decontaminate all items used in the clean-up. 9. Replace all materials used in the clean-up and ensure response equipment is in good working order. 10. Manage and dispose of collected absorbents and liquid in accordance with federal and state environmental regulations. Note: - Spill clean-up equipment is located on the main floor of the building. • The spill equipment list is as follows: - Absorbent Pads (see Parts Dept.) - Eye Wash Station - First Aid Kit - Gloves and Eye Protection - Fire Extinguishers • Material Safety Data Sheets (MSDS) are located in the Parts Dept. at the technicians' counter. August 2009 Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town Of Barnstable . Regulatory Semces Tlicm q Y Gamer,Dir adur 3AM&-XA Pubiie He;ahh Di io-E SS- 2�O Main sS l-I 4 ETf=113,IVA 0-bQ1 ' F� 50�-790-6304 0-cz: 50S4622-464A i a 5 SSfl �iP r �P—R=NO. DATE' PPLICA'I'-Tfl� FOR PERT Tn STnRF AND/0R UTf MORE, TEL�--N 111 G_ LLB.—, nw -T:TAZ, ,RD0US MATERI-AILS NAM E OF APYIICA.NT r x. OF EST- B-=Ta.au 1 c�Ci �ayv r�nn c e��l LDDRESS OF EST-,k3LI=l/ -T nn 1�r2 m� r�i r 0 y1t�LH0 �1'I U1711 < u-ITS j O S OI1E 0 �: YES � NO ►< w T ��PLICA�1'T IS A PAA7N�, I�N_A ADD HoNa A_DDAESS OF A cn o C9 N N rn �O Zat i I AEEIL?CA-I'IS A CORFQRATION: FED� 'L iD 1gICA7IO i 0. STDTE OF I I-C'ORPOAAMON _�L�T_A��A�1�HOi�ADDRESS OF; TRESID= C1:1t.11.u- 1 ��ilc�T 5 ?coo 5: HONE ADDIRESS 1 tX �� n\ c'►ir_� s �'^ Ho�/a z�nclwQlq MALI-21 RE0TJESTS Please mail 1Ie comPle1l-ed application f o=i tc the ad&zss below. In addition, please include tie qu"-d fee amount Mq-ke che,k pa able to: To*n of Babble. Our mailing add-ess is: Tom of Banm table P-a'ohc Heart Di7ision 2D0Main >Strzet Hyanazis; Kl� 026�1 FOR FA= REQUESTS Om' fIX nlmber is 790--6jN. Please iaz a colleted aapli.canon fo= L addz on, you nust E l the required fee amount (see fees at botto= of this pagz). Please make the check payable to: T o—,Yn of Ba�Lable, The check must be nailed.to the ad&-ess Estzd above. For further assis-mince en any rem above, call (508). 0'62-4b44 I � i I I I I I 1 I i I. l I I Town of Barnstable 0kI ME Tod Regulatory Services Thomas F. Geiler,Director Public Health Division 3ARNS•TABI,E. ' . 9 MASS. 1639. Thomas McKean,Director 200 Main Street,Hyannis, l A 02601 Wayne Miler,M.D. Office: 508=862-4644 Paul J. Canniff,D.M.D. Fax: 508-790-6304 Junichi 5awayanagi NOVICE TO A LL BUSINESS 0PER—AT—OR S WITH HAZARDOUS MATERIALS i IN BARNS LE The Town of Barnstable Town Council adopted, Chapter1108: Hazardous �d 1 p permit and Materials, a requirement for each business operator to obtaingallons or more Of m to remit a fee of$1.00.00 if one-hundred.and eleven ll Z�(an�or disposed of at a hazardous materials are stored, transported, particular site. STEPS 1 — 2 - 3: 1. Please co the attached application on form handle hazardous waste 2. Include a copy of your contingency p spills, etc.; 3. Submit the fee of$100.00 payable to the: Tows o.�Bc�rnstable. . - 2013. A late MAIL all of the above to this office on or before June 30,,Tuly �� 201 t charge of$10.00 will be assessed if payment is not receivedY Please feel free to vi ew the above Code, Chapter 108 Hazardous Materials on the To wri�Jebsite, www.town.barnstable.ma.us , which is located under the E section if you should have any questions or concerns. Q:\iazmat\jIaz Mat Permit Letter.DOC Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis,MA 02601 -' Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------ ------------------- ---- -------------------------------- ------------------------- --------------------------------------------------------------------------------------------------------------------------------------- y This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health iA Y`� �GUd� f do:C Town of Barns le BIKE Tp Regulatory Services ti Thomas F. Geiler,Director B" MASS. ' Public Health Division �ED 39. s Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT A m A LI.0 NAME OF ESTABLISHMENT L.Wd RoVor OAM A ADDRESS OF ESTABLISHMENT 1 0O /1S&.610- gwdanis TELEPHONE NUMBER 5?7�'•�I9t•DOyN SOLE OWNER: YES—A__NO j SR a IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL - PARTNERS: b Tomes .Adler_ 1I Almtoashdnlef A Matti idma [ I' A o19df M IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK S GNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 11 Or4*Jam' rotr HOME TELEPHONE# 58S•!7W? Haz.doc/wp/q Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis,MA..02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended yr revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2010 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I i Town of Barnstable °E1HE r � Regulatory Services Thomas F. Geiler, Director • �. BA ASS LE, MASS. : Public Health Division .� ht a +J ATFDMP�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT !/ � ADDRESS OF ESTABLISHMENT P 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.nQ 3-744(a3- STATE OF INCORPORATION �Y1 FULL NAME AND HOME ADDRESS OF: K --tb re I e PRESIDENT —1 (�r .1 1 G`r1 rC i e 1 Pt 3C.o TREASURER K TT CLERK • SIGNIRWE OF APPLICANT RESTRICTIONS: HOME ADDRESS__CLbp4 e HOME TELEPHONE # i -58S -]8Rp Haz.docA%p'q Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, 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 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 2 Town of Barnstable of r Regulatory Services Thomas F. Geiler,Director B"`AS& Public Health Division .. 94, ze39. �� '�Earu• Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 i �� 0 ASSESSORS MAP AND PARCEL NO. a�� DATE a G APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIAL o r cn m FULL NAME OF APPLICANT 71 � NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT 104 �Q/��✓�� / ��s /*4 TELEPHONE NUMBER SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTN S: 1-7ol2-.r-LAwl' Crcle- km,,J, , o.1-3cY IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0,13 �/V " 33 STATE OF INCORPORATION MA SSG CA1X-e45 FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK Ar t'S10NA OF APPLICANT RESTRICTIONS: HOME ADDRESS /7 02-r6L-stAJ C; ' ` 1S HOME TELEPHONE # i May 25 07 03: 03p p. 1 LAND ROVER CAPE COD SPILL CON T INGEN�Y PLAN 1. EVACUATE THE AREA IF NECESSARY. 2. SHUT OFF VALVES,PUM?S,ANID ELECT RICAL I EMS AS APPROPRIATE. 3. REMOVE OR RESTRICT ANY POTENTIAL IGNITION SOURCE FROM THE AREA IF THE MATERIAL IS FLAMMABLE. 4. COVER OR DIRE ALL SUMPS AND STORM DRAFTS. S. CONTAIN THE SPILL BY USE OF ABSORBENT PADS,`I`IIEN USE ABSORBENT MATERIAL OR ADDITIONAL ABSORBENT PADS.CONTACT SPILL RESPONSE FIRMS IF NEC;ESSAX-Y,TO ASSIS T IN THESE AC iVI T YES. 6. REMOVE ALL ABSORBED MATERIAL OR CONTAINED LIQUID AND PACKAGE IN .DOT APPROVED CONTAINER USED ABSORBENT MATERIAL SHOULD BE PACKAGED SEPARATEIN FROM LIQUIDS. 7. LABEL ALL CONTAINERS WITH TIME TVPE OF WASTE AND START DATE OF COLLECTION. li_ NOTIFY THE AFTROPRIATE AGENCIES. 9. ONCE THE SPILL HAS BEEN CONTROLLED AND MATERIALS COLLECI LD, INSPECT THE AREA FOR CLEANLINESS AND DECONTAMINATE ALL ITEMS USED IN THE CLEAN UP. 10. REPLACE ALL MATERIALS USED IN THE CLEAN UP AND INSURE RESPONSE EQUIPIMENT IS E4 GOOD WORKING ORDI R. 11. 'MANAGE AND DISPOSE OF COLLECTED ABSORBENTS AND LIQUID IN ACCORDANCE WITH FEDERAL AND STATE ENVIRONMENTAL REGULA1TON& 12. FOR ANY SPILL THAN 25 GALLONS,THIS PLAN SHALL BE IMPLEMENTED AND PROPER RECORDS OF ACTION SHALL BE KEPT ON-SITE, 13. SPILL CLEAN UP EQUIPT.IS LOCATED ON MAIN FLOOR Of BUILDING. 14.THE SPILL EQUIPT LIST IS AS FOLLOWS: a. absorbent pads d.eye Wtrsh station b. doves and eye protection e.fire extinguishers c. first aid kit Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, 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 30, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health - r Town of Barnstable 'pFt► Tok Regulatory Services Thomas F. Geiler,Director 1M�` * �pf * BARNSIABLE. * Public Health Division 9qj s6; �0� 39. 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. 6� S- DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS r-- FULL NAME OF APPLICANT j � n NAME OF ESTABLISHMENT_ 1,14a v ADDRESS OF ESTABLISHMENT �b.� OJ��/C s I-&A-04/E TELEPHONE NUMBER Sb c — 724 �- 4-6- ( SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL f= PARTNERS: 02 A �v� do j g � -6/� ' g O.L2 6/ 1-24 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AN�IOME ADD SS OF: PRESIDENT / ,�/ —J.7 04fC>14-h/ TREASURER A1 CLERK 4krURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Application Forms\HAZAPP.DOC Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis,MA 02601 Is Hereby Granted a License, FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------- ---------------------------------- ------------------------------------ -------- --------------------------------------- --------- ---- --- ------- ------------------------------------------------------- -------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ------------------------------ --------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health • L Town ®f Barnstable Barnstable okT►E Regulatory Services Department • �y °. !1�-AtnericHG�y BArasrABL>a, Public Health Division 9 200 Main Street, Hyannis MA 02601 Arm ru►�'" 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT • �.� rr �, TELEPHONE NUMBER ,/ 4 �.— O© f SOLE OWNER: YES NO C- IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS'OF ALL PARTNERS: ) o r rri IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.1>43 77414053 STATE OF INCORPORATION rrx FULL NAME AND HOME ADDRESS OF: PRESIDENT 1"'1 TREASURER CLERK • SIGNATURE OF APPLICANT RESTRICTIONS:. HOME ADDRESS aJXrf (-- HOME TELEPHONE#qg l- 5'95- '1$&-7 Q:\Hazmat\Haz Mat Application2008.DOC �o Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 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 K Town of Barnstable Barnstable �� Towti Regulatory Services Department o� ;eficaCfty DAM srnst.e, + Public Health Division "9. 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT @ NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT lDo a TELEPHONE NUMBER rr SOLE OWNER: YES N ,3. c1; IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRES& F AL b PARTN Rom_ MO W--r I N t 7 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ()(4 ]�_, STATE OF INCORPORATION FULL NAME AND HOME ArS OF: PRESIDENT TREASURER CLERK OCG W D 9" SIG 'TIA APPLICANT RESTRICTIONS: HOME ADDRESS We HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC f Nam 25 07 03: 03p P. 1 A _ �� LAjF ca FF,i OVER ufc CAPE COD t•!D Sf ILL CO llVCsl',1Vt_.Y Mi.,A1`V r - a. E V A A i L TRUE As-E.lsA itA' NlLi..L'S3KR Y. 2. SHUT OFF VALV—ES,PUMPS,ANID ELECT R[CAL ITi:MS AS APPROPRIATE. - 3. REMOVE OR RESTRICT ANY POTENTIAL-IGNITION SOURCE FROM THE AREA IF THE MATERIAL IS FLAMMABLE. '4_ L JG➢.1 3lJf`-t0.G34 a'r AT a... JVrFaF 5 hlra if SaSCMIkilvlar.li.jtjTi i-E., 5. CONTAIN THE SPILL BY USE OF ABSORBENT PADS,TKEN US.r:ABSOKFfE!I MATERIAL OR ADDITIONAL ABSORBENT PADS.CONTACT SPILL RE,SPONSE FIRMS IF NECESSARX,TO ASSIST 1N'InESE AC'-I l MICE . ,n,n. r.v r�ne„tr� w,r� •gsTa r rZn !`g1Ar'Y+�'AT1C i T137T AND f. ioZ V1 101E ALA,AB`SORBE,i< i�in ai ta.Pa i, 4CO it OMD Err Lt J — PACKAGE IN .DOT APPROVED CONTAINERL USED ABSORBENT MATERIAL SHOULD BE PACKAGED SEPARATELY 1��.ti�O LIQUIDS. 7. LABEL ALL CONTAINERS W)T-H TIME TYPE OF WASTE AND START DATE OF(,OLLCCWN, _ n- NG T i t 1' T H A$PROPI e i a E AGENC 5. 9. ONCE TTrE SPILL HAS BEEN CONTR04LED AND MATERIALS COLLEt;I'LVV, �_ INSPECT TOT AREA FOR CLEANLINESS AND DECONTAMINATE ALL ITEMS USED IN THE CLEAN U P. 10. REPLACE ALL MATERIALS USED IN THE CLEAN UP AND INSURE RESPONSE Et2U1t�iME I'IS Ri COOD WGICKISC ORDER- VI. MANAGE AND DISPOSE OF COLLECTED ABSORBENTS AND I,IQUIID IN ACCORDANCE WITH FEDJN:XAL AND STATE ENVIRONMENTAL ii GULA i-IVIS& 12. FOR ANY SPILL THAN 25 GALLONS-,THIS PLAN SHALL BE IMPLEMENTED AND PROPER RECORDS OF ACTION SHALL BE KEPT ON-STYE. I3. SPILL CLEAN UP QUIPT.IS LOCAI—E.D ON MAU FLOOR OF BURLD NG. 14. THE SF&L EQUT.PT LIST IS AS FOLLOWS: a. absorbent pads d.cyc wSk sb station b- plover and eye pro4cctioye e. fire extinguishers c. first aid kit S. i Number Fee COPP 401 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, 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, 2005 unless sooner suspended or revoked. ---------------------------------------- SUSAN G. RASK,R.S. WAYNE MILLER,M.D.,CHAIRMAN January 10, 2005 SUMNER KAUFMAN,M.S.P.H. THOMAS A MCKEAN,R.S.,CHO Director of Public Health 9 Town of Barnstable �„U\ °PIKE T�jtm Regulatory Services ° Thomas F. Geiter,Director x x BA M LE. MASS � Public Health Division .p ASS �O. 1639• �fD MAS a Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 3a-7 - dSq ASSESSORS MAP AND PARCEL NO. �o� DATE D APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ��/�6 ifV?'o ,-,e0v1- lam'►w) /tail,,% 6,W-g NAME OF ESTABLISHMENT �-A"s1 U kD aD, ADDRESS OF ESTABLISHMENT D /JCL ih'f/J �� awl, TELEPHONE NUMBER _- r. a'. SOLE OWNER: YES__�,/NO I IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS:. � // ��ookl,110�6 / oJA d 0 le ��2 O�T n C rc�e- °" O 36 Y IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Q - 3 y b 3 3 STATE OF INCORPORATION �ICL S S FULL NAME AND HOMY A S OF: V PRESIDENT tVYet t oL 7 O 4,4 i TREASURER • AMES 1. AD LEA ;)e3 on6an Al r q- p 1 rj yS� CLERK fFNtEs S. A I1lC2 ad'3 0 n9A/i A tA,,V— a k /lA Ogg y� TURE OFF APPLICANT RESTRICTIONS: HOME ADDRESS I�I o ��, C�i '� l n '"` C) HOME TELEPHONE # 7 76f 7 LAND ROVER CAPE COD SPILL CONTINGENCY PLAN 1. EVACUATE THE AREA IF NECESSARY. 2. SHUT OFF VALVES,PUMPS,AND ELECTRICAL ITEMS AS APPROPRIATE. 3. REMOVE OR RESTRICT ANY POTENTIAL IGNITION SOURCE FROM THE AREA IF THE MATERIAL IS FLAMMABLE. 4. COVER OR DIKE ALL SUMPS AND STORM DRAINS. 5. CONTAIN THE SPILL BY USE OF ABSORBENT PADS,THEN USE ABSORBENT MATERIAL OR ADDITIONAL ABSORBENT PADS.CONTACT SPILL RESPONSE FIRMS IF NECESSARY,TO ASSIST IN THESE ACTIVITIES. 6. REMOVE ALL ABSORBED MATERIAL OR CONTAINED LIQUID AND PACKAGE IN DOT APPROVED CONTAINER USED ABSORBENT MATERIAL SHOULD BE PACKAGED SEPARATELY FROM LIQUIDS. 7. LABEL ALL CONTAINERS WITH THE TYPE OF WASTE AND START DATE OF COLLECTION. 8. NOTIFY THE APPROPRIATE AGENCIES. 9. ONCE THE SPILL HAS BEEN CONTROLLED AND MATERIALS COLLECTED, INSPECT THE AREA FOR CLEANLINESS AND DECONTAMINATE ALL ITEMS USED IN THE CLEAN UP. 10. REPLACE ALL MATERIALS USED IN THE CLEAN UP AND INSURE RESPONSE EQUIPTMENT IS IN GOOD WORKING ORDER 11. MANAGE AND DISPOSE OF COLLECTED ABSORBENTS AND LIQUID IN ACCORDANCE WITH FEDERAL AND STATE ENVIRONMENTAL REGULATIONS. 12. FOR ANY SPILL THAN 25 GALLONS,THIS PLAN SHALL BE IMPLEMENTED AND PROPER RECORDS OF ACTION SHALL BE KEPT ON-SITE. 13. SPILL CLEAN UP EQUIPT. IS LOCATED ON MAIN FLOOR OF BUILDING. 14.THE SPELL EQUIPT LIST IS AS FOLLOWS: a. absorbent pads d.eye wash station b. gloves and eye protection e.fire extinguishers c. first aid kit Town of Barnstable ' °FINETgy� Regulatory Services °s Thomas F. Geiler,Director U� '" HASS. Public Health Division ibgq. ♦0 '°rFc na+°i Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT r NAME OF ESTABLISHMENT Gl �� IG I�� ADDRESS OF ESTABLISHMENT )0 0 fty f I5�V (e ' t`��('%t Vu S TELEPHONE NUMBER �J C� �I S " 0100 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 '/lS5�GL'1u Pil I FULL NAME AND HOME ADDRESS OF: PRESIDENT Fr r ` 4 Ghet r-3.5 TREASURER C --i-h(� 'R t c ' o r CIE CLERK vV : l 1 C a w\ e ro u)e t SIGNATURE OF PLICA RESTRICTIONS: HOME ADDRESS I kwy HOME TELEPHONE# Haz.doc/wp/q P Town of Barnstable a4 °FINE ti Regulatory Services 0i9 �"� , °• Thomas F. Geiler,Director I Public Health Division to i639• �0 , AIEDM{►'�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. S- DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT L9 NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT Zd.4 !s - oa 4 o/ TELEPHONE NUMBER 7 7 b SOLE OWNER: YES Z- NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF C-n PAR RS: /1n'_ J o� C � uc _ c- b '�° -_j o 2 - � 8mac._11 / ��o AA , (f/4C%� qL ci- a '36 f-, CIO - IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. dTK STATE OF INCORPORATION FULL NAME AND HOME. DRESS OF: PRESIDENT TREASURER CLERK SI;'NtOF.APPLICANT RESTRICTIONS: HOME ADDRESS /Z Ole74-a AA 5;s-1 HOME TELEPHONE# � f IHE T f `° TOWN OF BARN TABLE Date: .....1. ... .........:�.3 S ❑ New Application p , ,,S1AB>� ; LICENSE APPLICATION D,Renewal 9M6 9. `eg 200 Main Street Hyannis,MA 02601 ❑ Transfer � Iblb I` 508-862-4674 El Other NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREAUSES 4 Name of applicant/corporation: CA PE A LI� �(Ze v L L C. Home phone#: Fl_ ��s' `7�P 7 y ..................._...._._.._..._..._.._....__........_..................._..._............__._._...._..................._......._...... �1 ....._._..........._...._............._..._...._._.._...........- BU V A 2 nl S7 A 3 I .A..F'...7 7 cFS-...��.;/.. Address of applicant/corporation:_._._.. __..._..__.__.___.___..___.._..____._._..__......_..__...__.__._....._.___:.___.._-_.____._._..._._._____.._...__.... Business phone#: _.............._......................._......._..._._..----...._....__... ........__.........- y.. _n n.. s.- ...-- ti s s.__._.__..._ .. _ .._� D/B/A _ LA n1.1�__..._f( _o�.Ele_..__Ca AP.e ..._....._._C't'.3.._.... ........_.........._............_........._..._...._........ Business phone#: Business location: 1 { __.! trn t 8•A G S,f t p�.a(� 1 Businessmailing address: ..............._..... G." --- - ....- - ........_..._...........- --.._.._..._.__...__._....._.... --.._..-- ..__... .. _.__......._..._...__.._..._._....__. ...._...._.........._.._._..:......__........_..._..._..--................. Local business address: (� Local mailing address: __._...___..______._____..Sc^_'.- _.__. ._._ LICENSE TYPE: ��C S S 4+0 Dect le t' Annual Seasonal .............................................................. ® 0 HOURS OF OPERATION: 7 LG _...._.__... 7 1'�..._..... FID#:...._._t)�/._-_37 Y.1A.3 3 Name of manager: "" � t-1 _._..--- _.._... -....- :• Local mailing address: ..............:............................................................ ........ ........ ....... ....... ....... ...... ...... .... Manager's Permanent mailing address_............ _ i�IGS '`_ ... '`..:..: :.._ .... ":° �l }. Manager's home phone#: /._�_�S ?,Pf.7 Business phone#: 5.1 ........... `� _ ..................................._............_. t` Name of roe owner: )) kj , s 06 r 0-� /C e Vu C G d�4, _.r�4 r,✓• #-I property dY - ......... .............._...._......_..........._............__...._...._._...._...__...__..._...._........_........_....._..- --S ..._......_'t. ........._s....s._�_�_.._.........._..........__.._...................._....._..._.......... ASSESSOR'S MAP/PARCEL#: MAP .............._3._a�......�....... PARCEL 5..`.....C ............... List any flammable substance or hazardous waste used in business(specify): Applicants must contact the Building Cooft)ssioner's office, (508) 862-4038, the- Board of Health office, (508) 862-46441 and the appropriate Fire District office to schedule inspections. Signature of applicant' A ................................................................................................................................................................................................................................................... For Town use only REAL ESTATE TAXES PAID IN FULL PAYMENT AGREEMENT IN EFFECT ON ,i s IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES ❑ NO ❑ INSPECTORS APPROVAL Capacity set by Building Division:...: ........_..........._............. ... ..... .............. Building/Zoning Date Board of Health Date ..:.:.. ...:..... : .._.__._._...._......_..__. _.. fill } Wire .......... ................................. ........ Date ................ .. _......................................... Plumbing .............. ...... ........_... . ...._........Date ......................... ................. Gas ............................................................................ Date .................................................._......_............... Fire District ............._........................._....................................._... Date Comments:............................... . . . .. ............................ _....................................._. White-Licensing Authority Canary-Health Division Gold-Building Commissioner Pink-Fire Department `oFIKE*oyti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAR,1; . ' 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT fE0 MPS Business Name: 0"-y7d, gov Date: Location/Mailin Address: r U n® Contact Name/Phone: 00yi Yh�c► �-7 >r'r��5`f y Inventory Total Amount: 7c22300 S L MSDS: V Y4F5 License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: kb' Floor Drains: Emergency Numbers: y�� Storage Areas/Tanks: -tSa 0,It J3... (501-, i w¢v 51s—"kl)IaS ZrJ Emergency/Containment Equipment: Waste Generator ID: q9 ?/ A Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: 0-,)n 6 , Other Waste Disposal Methods: 0; b nr,�J a,4 5;� �� 1 6 0n'n ;--- 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 ,,diii�sposal of 111 gallons or more requires a license from the Public Health Division. � °�Antifreeze 't 4 � 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 r✓ Motor oils �c��sy� ,,,-'fa) ►� 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 6 1bzS 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: I VO N C- ORB1=fiiS: INFOR TION/RECOMMENDATI NS: Cy k 'e G )Q u Inspector: CO- Facility Representative: JAC WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS I"E roy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 eA MAr,S- .� 200 Main Street• Hyannis, MA 02601 �PrED MP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: LAVIX Rave-r Ca C.IQ Date: Location/Mailing Address: 100 -14A,S Contact Name/Phone: �>e.vttos Ge,1+0' ,- - 1 9.eg, ►14ge Sob 0'oey4t Inventory Total Amount: "'�`�3�qk'� ��olb SDS: �1111,ILIA "J 'License#: y01 CAA-3 Tier II : n Labeling: © Spill Plan: ye,5 Oil/WaterSeparator: Floor Drains: Q0 Emergency Numbers: Q S 6114A <5 Storage Areas/Tanks: Z�Ogod vJ&Io�6011 A�rftwQv&fSI tL qg-0 AyTw,tJ,, luoo 0,0,,44-T,4 5,0C>t, v� io j Emer enc /Containment E ui ment: 11 VOr w' w vo�xs -r ti "�S "`�"'�""""`~'� noTM Waste Generator ID: A40D 2-7169 Waste Product: �-}S ca►a�C 2►tif� cee �j I Date&Amount of Last Shi ment/Fre uenc : I (o 41 -z?clvr Licensed Waste Hauler&Destination: a ny (2Q4i. t^ruwSfio ti, IQJ= 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. (3o Antifreeze %`7 k 4 9L o45,6, Dry cleaning fluids !r Automatic transmission fluid S Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers _ Hydraulic fluid (including brake fluid) f O Windshield wash I L 0 -2000 Motor oils '5,24 5<fiSs+%sav>mtA Miscellaneous Corrosives Gasoline,jet fuel, aviation gas r'S°, Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants q Miscellaneous petroleum products: Road salts grease, lubricants, gear oil SX% bo ( Refrigerants 2,x 1-0 � Zo 2,b Degreasers for engines&garages i°'c��^�1 Pesticides: Caulk/Grout '�� insecticides, herbicides, rodenticides ►!!r Battery acid (electrolyte)/batteries 1� 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: QAD 1ti Nh,C. Inspector �--- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °p IKE to Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RnRMA-SA LE, 200 Main Street• Hyannis, MA 02601 ,b,q ,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MP'�a Business Name: L V'Cov c f C. Date: F )3 /6 Location/Mailing Address: too Y "l.e-_ 14ptnyits Contact Name/Phone: DQvnv►%s Col�o,ti - p4r�s y�nt< Sob- '7'18 - 004� ?.►ti. Cooae<-(1e►ti vKyr n.'DDoq q wm�k eve 5� Inventory Total Amount: � MSDS: ,eS -- j License#: P Tier II : No Labeling: YGS S a (94(Spill Plan: e,5 Oil/WaterSeparator: 1J A Floor Drains: rJo Em rgenby Numbers: �es Storage Areas/Tanks:?°c Irk kS Wad 0113JN%dloaf5 �gn.•.W-r\.>ws{Lo,t�&,A-Vovs,c�c1« Emergency/Containment Equipment: &,r RYA 1.60 S ��y w Waste Generator ID: n o 7 tb RD_ Waste roduct: O11 ��! �s aK , e. Date&Amount of Last Shi �ment/Fre uenc : ahs c 1Ic4-1W S1Zo/i r t��a I ��z.x/y< s ckaxaf Licensed Waste Hauler&Destination: 0-'�ylee�- t��-avt5�o.ti ►Q= Other Waste Disposal Methods: 'V't 1 flocs 4%A-X a''IvL+,q«e-?e, - G lei rt,4eSf" vw vu- LIST OF TOXIC AND HAZARDOUS MATERIALS ND vow 1 o J 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 2*S57 WMk-11- 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 V-0 As'( Motor oils 2X555/kSs 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 3X%S Refrigerants ./ Degreasers for engines&garages yag 1 Pesticides: Caulk/Grout c`ea� 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 V Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" y-s f�l ��,,,,�, (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: oS� - VAAk air 0�J ��el.ads w I,, 1•o GIB w }1,`, ValkN1. k -r 65cvv J. Se, . INFORMATION/ ECOMMENDATIONS: n 1.0C-k- ©p a 5 ,11 J o.( GC D Inspector: Wa`b�'e��►�`a��-�LSX> �' qwy �„�,� (q��( Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS AtIL ca.� R,4� +o C10-`1(- 5 V4kVo< 1+aAk5 . Number Fee 401 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Land Rover Cape Cod 100 Barnstable Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------=----------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Q 'i Town of Barnstable WE►o Regulatory Services Richard V. Scali, Director .0 BAMSTABLE z '''RMAS&"�'� Public Health Division �. p 1639. 10� wB°'`"wno'�°a°,ui.s�"�"osrvmie anm�a� 1639-2014 r fD Thomas McKean,Director �� 200 Main Street, Hyannis,MA 02601 ' Office: 508-862-4644 Fax: 508-790-6304 s . W 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 Ist—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 V'S A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. .Z ,05& DATE &/f.k 7 FULL NAME OF APPLICANT:&W todn LLC NAME OF ESTABLISHMENT: Land /?'61/Cr 1.t�1t7� C.D4� ADDRESS OF ESTABLISHMENT: /100 �ns�iib�l l�. ljuQ nis MAILING ADDRESS (IF DIFFERENT): ev�T A Oa339 TELEPHONE NUMBER OF ESTABLISHMENT: .50f- 17f, 000 EMAIL ADDRESS: SOLE OWNER: YESANO IF NO,NAME OF PARTNER: See pr'rtG;OQI S /!LlWJ below. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME v L.LC 9I' r e Tctrn�S A&1 �,_YI't10.6er IF PREPARED BY OUTSIDE PARTY: SIGN ICANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 III IK rE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 8ARM5�LE, ' 200 Main Street• Hyannis, MA 02601 �'°rfOMP�a`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: < C C Date: y �s Location/Mailing Address: JDD kc +" -e- n Af-5 Contact Name/Phone: 'a - -7 7 - oo y e f, C o _ t-L:5 Inventory Total Amount: -�o— MSDS: Li en a#: °} � Tier II : IJ o Labelina: 1,f n o J= Spill Plan: Oil/WaterSeparator: NIL Floor Drains: Emergency Numbers e5 Storage Areas/Tanks: oo qrO e p sk vi\ c �1 w t1 v-Argo"153 n e e Emergency/Containment Equipment: 1 11 �2 � 00,g�� Jt a\ b� lyvl�.Qo( A4 Sy. Waste Generator ID: Al %-7l O Waste Product: Q qt Date&Amount of Last Shipment/Frequency: f 2 ► b ,f r< scree g- 9'/s i� I 4r Fsc� ►tee" Licensed Waste Hauler&Destination: -'*�W44 X-- C ra Other Waste Disposal Methods: ,I cs eo e�►� ac c 5 7 �r ti �, LIST OF TOXIC AND HAZARDOUS MATERIALS N 0 vvVL'1 n( Omw,L ,vx NvweeAv ONQe-Iaf,)-r \Ng�� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laft of MA, hazard us material use, storage/and disposal of 111 gallons or more requires a license from the Public Health Division. yAntifreeze 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 v,(� 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 4 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:DIA0oo'r ORDERL ,, k K oo,(6 SA(� . s a9e. o e-e 4s er INFORMATION/RECOMMENDATIONS: M oV,& fII +o Cc4.41b1z oGa�'�oA�. C�&Ce� Dvl��N vu �' �S�� Inspector: in Facility Representative: 1JI( 11hft=- V WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: / //y TOWN OF BARNSTABLE low. TOXIC AND HAZARDOUS MATERIALS R FORM NAME OF BUSINESS: �-Q�^� dove-r 5 AA e 6,� BUSINESS LOCATION: !flo dgarKS�-abler R&e_ , tlyAvlrl I S INVENTORY MAILING ADDRESS: Jg w-- TOTAL AMOUNT: TELEPHONE NUMBER: 5013 —770^oOyl 900 f tl A"s CONTACT PERSON: a row � eh 6-t -o nt1 M r b�n✓tl s o �6K, ar'l s � V_ �' P EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 5 INFORMATION / RECOMMENDATIONS: 9 ,Yec,o Fire District: Alahrl,5 lP,ak�wl aQ�r, ,ws ijoyW__ `t-k4t, .+ Oo+ 4 acT.,«e �•.�-,l rcQarr ✓ ,3)A/,eray t,/dl& JH.kytck>U-covti-4K+s 0&5 ob5�ryr�.Q o,�r{s �- -}-a l.� iws 10& W JCK+s,-+�•s�Oos�-d� G--ew�c�►}�r�; P eris ctla f-swI oo ,►,.�nd.1a" ly�Y�a�s��c°� � Waste T : M 7816Sg yoo� Last shipment of hazardous waste- Name of Hauler: AAtK64Pc"L,9U o/ awl Destination: Wcjste Product: nt',4ecq_e_ Licensed?(& No , NOT : Under the provisions orCh. 111, Section 31, of the General Laws of MA, hazc-frdous 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 Antii eeze (for gasoline or coolant systems) Miscellaneous Corrosive 0 NEW lJ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including(brake fluid) Refrigerants Mot Oils / Pesticides lti 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 LL 4 vtVe4A70c 64Av, 6e, Laundry soil &stain removers OF (including bleach) 1 yicj ��Zllc�'D�' — a��► ,an, d Spot removers &cleaning fluids (dry cleaners) Gno°t c.r V&O+z R vt i,(reG2_Z /rho 2-�OJAI Other cleaning solvents Bug and tar removersYl� q, vt�t,J G>>n�6/11�1y� GJ�cS TtS�I/65ya) Windshield wash .# toII wo 54W,401et4z) IYl ovfXon,Tt WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staff's Initia Date: //1 /-24J TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: / ort 61P6 BUSINESS LOCATION: /off gRN,S>7�F3CE ,��. &,+A is INVENTORY MAILING ADDRESS: A-s TOTAL AMOUNT: TELEPHONE NUMBER: �� _v© 4., Gp-U-44S CONTACT PERSON: E>✓NrS C/04,77111 P Ir3 1�41`1/4� EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: V&e/i'/czc 3A-2E,s A-ivo6 S L�cV/cc iA/',�L-7K INFORMATION/RECOMMENDATIONS: ,��/� i'IXC >=X774XVI-` -1 Alf-'&-' Fire District: Z DA7C, 771r- Y✓Asw XA-7/aa/ Is ir-ir,Uc1-761JAL.SF1cz- 14ArEV-iRL is ,Q✓,¢& I-IVA&XIIS M C 5 CoAIW Cr 77/4� SEW. /-/Q'_)U5 E PA M 1+A11) Pe f Z W/0 / 01140072• r,7f6 FtA-Al Si`/T e-Q 6e a A " Alm lW7z'11tAwaC4. 6 VVIV, 6�e5, L°Cf(776 a;6,r' 7W 5_1XifG1_lk'-C E/{/C1.0S/,VC. 771E TW6 AB6er6.4 1 1JI) 5M4A46 rA-A1<S AZ)77QCciur m vlt�" Waste Trafspertatkm—_ ` �p��5 av°Last shipment of hazardous waster-�� Name of Hauler.• Destination: &-Qi ,,/` 41JSVn1,ITT Waste Product: Licensed? es No NO TE: Under the provisions o Ch. 111, Section 31, of the General Laws of MA, hazardous materials 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. C!eAj 17) Observed/Maximum Observed/Maximum IaAf_ &C 77<F 130 thiAZG Antifreeze (for gasoline or coolant systems) Misc. Corrosive 6- rp P NEW SY USED Cesspool cleaners V1771' &US`y 'QC` ' �� /)5 3"C;1Z�Lotii Automatic transmission fluid 64aR IVslh"A� Disinfectants �aNCx.c'TC Gt..�� Engine and radiator flushes 16w,11,41oCk 1.41 Road Salts (Halite) QuR RT"/30rnt5>a/ � -Hydraulic fluid (including brake fluid) )otg7s V PT Refrigerants Motor Oils L ZioP ,457",s7ZPesticides NEW 3� USED �x'� iO1%°G" ') Insecticides, herbicides, rodenticidesi--CAFgciry r-biz ( ) Gasoline, Jet fuel, Aviation �- �� GuLZ Photochemicals (Fixers) i &'XrMe'r,(! �vr. L7`Diesel Fuel, kerosene, #2 h500 C-ift c4p4ciry- � �� NEW USED f'ArrS �e�r h Misc, petroleum products: greaseQvw�p> Photochemicals (Developer) lubricants, gear oil /3v:7z&s NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout i,r- Swimming pool chlorine Battery acid (electrolyte)/Batteries � ZOO Lye or caustic soda Rustproofers Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint & varnish removers, deglossers (including chloroform, formaldehyde, 3 Pj,4•y C*NS, QU,0"-r Misc. Flammables 5v�S`� r& hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers 4 LW (including bleach) p`L //L A'S P-A/VE76 eel- Spot removers & cleaning fluids ATELY 4-Alb 1-71tV &SPoS'e-A aG >N A (dry cleaners) ?1GlMPS - Other cleaning solvent LL69WCv-"V C�f(aC�`E 3) /6AIieV 77iFFiiGr 7JGLl�►�/-Ud' >�lsi'tZnc� WILL SE Bug and tar removers rGoc%- Cc&-AAJ&f- PLKrvg.Q&b >,rl Windshield wash f 6,eUk(CAI /NA�Ms WHITE COPY-HEALTH EfEPARTMENT/CANARY COPY-BUSINESS r� TOWN OF BARNSTABLE iyd ' UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME WARREN BUICK, INC. ADDRESS 100 BARNSI'ABLE RD. VILLAGE HYANNIS MA LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL ;6` zsrek�-- areegt—deo 1,999 gal gaselip,s Back of garage building waste oil 44 (Give same information for any additional tanks on reverse side of card) �3/3� DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS y � .1 r• .. I *• 'r^ s ti`r .�.'Y � 1 a. J ' a { r �. a '!I . .t•. '1 . €y J+S,y fir a.^{i.� { August 11r 1g80 _ e" r a . ' ... _ + !'Y•vai .k F, Z ,. 1 e a A. ' YF • l ; fir• f ..� ¢•"P '1 ,{�• >X. . • ; • e. . _ ! tl Manager •* Warren .Buick, nc.',` F _o '100 Barnstable Ad.•. Hyannis., Ma.` . N , f. T r , ~ Dear. Sir - r r �y . , . '{•� Y. iiie. information io You'-returned,return t ed` u s nd ca o i i ed h �a :.. �' t t e e of �our f g Y underground. fuel tanks' as rbcing- thirtir-eight~;years old: x ,• You must have these tanks tested,using the .:Kent--Moore Pressure Tert :by November 20 •'1980. IPlease submit.'testlnq results and .their •interpretation .to 'thi;s".,office' prior to November 20, 1980 zn.,addition, this test must 4be.,performed''annually .arid the- results' sent to this,offi6d. - For` your-•convenience; we' have enclosed >a ,list listing of- co#npanies"who : . x ^ aH perform ths� testing You„may, al'so utilze'-any k i . • . •. .. 4 Y qualified to perform this testing* x .Very truly, yours, dohd M. .,Kelly x. ng Director of Public Health JMK/mm ; ; r encl. l ••m a I a :F . fir! ! �F, �"{ • .. � {' -. aN, y n f ' e a sly: ?. .- ,. • ` _ 'y :. NA.1E LOCATT ON Warren Buick 104 Barnstable Rd. 100 `Barnstable Rd. Hyannis Nyarmis3 . Maser 37/56 12/9/29 DATE FJTD 1973 ?fiarch 26 MA[-, n cat MAR - 5 197 Via ►'^ " 197J 22 1980 WAR o 81976 MAR 17-1977 TANK 70 TEST CAPACITY From ! F] Station Chart Oy most acturatn ,r Nomiml Capacity 7 tD a uopaonv chart avado0lo �i V ;,J Took Manungineei a Chan / Id•nUIY eY DOUIIOfI ( Guw^e i Gauun• �•' Company Engineering Data J ' C( Ia titan Joust ar to True Capacity p 1 Chans aupplfad with T5T7 �.ana•no Guo• Sao Section"DETERMINING TANK CAPACITY" I� Other I FILL-UP FOR TEST Stick Reading& Total Gallons •j ' to Ye In. Gallons as.Reading Stick Water om _ before FilBso '-up1) _•• Inventory to V.in. Ga11onD � --�C^•� '7 i Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY J Ce Tank Diameter JJ %�� ///• -�l ' G�GC •B /D l 0 Product In full tank(up to fill pipe) b I SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM Sae manual factions aoDlicablo.Check below and record procadure in log(26). �'•'Stage I 1-1 Water in lank � High water laDlo in tank excavation � Lino(e)being Ioatotl with LVLLT ,• G Stage II TEMPERATURENOLLIME FACTOR(a)TO TEST THIS TANK (617)432-4236 Is Today Warmer?G Colder?❑_•F Product in Tank_•F Fm.ug Product on Truck_•F Expected Change(.or-) i � � 1 Thermal-Sensor rosding after circulation 'may�'1E,L •F Mena Naaasl Dig-to par'F in range of expected change 73,2�1e JI v'i'S {al i�l P&TA\tK SERVICE ag s FEATURING RENt-MOORE TESTING EQUIP. �j F,C=� X`�00 � � a a / gallons ' 16 0l quantity in cosfticlont of expansion for volume change in this tank full tank(10 or 17) Involved product pot•F P 0.BOX 224 `, C JIM CHASE HARWICH,MA 02645 ..4�G7 .vZ 7 4. This Is volume change pot'F(24) Digits per•F In toot ea Volume change par digit- teat Range(23) Compute to 4 decimal pie... factor(a) HYDROSTATIC - HET VOLUME LOG OF TEST PROCEDURES + .PRESSURE VOLUNF UEASURE91M M TEMPERATUIL WRPEIISATION ACCUMULATED RFCORD EO.001 CSL USE FACTOR(a) CHANGES CHANGE CONTROL EACX READING Sandpi0•Lrral Tempantwil At Rigs trial rxam .•lachaa Product�n Product Chan Adustmant OdF Record details of setting U I e.- •Computation Tow Fn0 CO.. i 9 P !xradmII Graduate flaDlacad(-) Tharnal Higher+ Icl'(a)' Volume Mmus I • dna funning fast.(Use full tla, 8aemmng Lrvsl a Senmr Lower- Er anaian♦ AI Lov lorol callnr length of line it needed.) ! D Eaoanslon I.1 or !leE I al wMan a•lam afar _ _Product Raading (a) Caap•CtiOa— CMnP D•t haur �R till - fludinp fleatond Raedme Raamng Racoverrd(+) I Contmdion 1-) (AFPA uitrru) i aOOM-a77(T) C. Y��x '� ,—ro Ihd/'✓ !`�a L•a � i r/� Tr i J�i ..-� i''� � Lr C.':� 4� (l:p L�ti 6:• �s �� -P`_. �/� tri l 'r•4.'� ((� •� I� rr `7 I "�-� i J ?(.'�'l I� ��C ..Uf�� . . e,�g L 4ILL] t� J 13 ) 4 su e c:.Al) 3 3 9- e: ; )VV,Z4, 'y�l !(`'! I r(.r, f- ! `- .I S.3� f �; �. :'z a G�;_ `- ; �IK I , 'I)—^> ! I I I I I I I �Cs41 '1 ! i I 1,-1 -4 Fella _6 i ,I _ I N.—ar S."O..Oil Dwt. Add— No.card SU.atls) Gm sun o•t•a,To.. " from TANK TO TEST CAPACITY Sutton Chan BY most accurate 4��' Tank M...factur.'a Chan ��/a Nominal Capacity C.pacity Chart avaaabla �d ieMun or oawuon wuona G•�to^a �`j CO.P.M Engineering Data /+ Is there doubt as to Tru.Capacity? �J/ChaM wpolia with TSTT w, Bnnd and Gr.a Sea Section"DETERMINING TANK CAPACITY' �`I Other Stick Readings Total Capons FILL-UP FOR TEST to tr be. Cations ea Read" Stick"WaterF Bottom .--� �� ✓ bNOre i1Fup .. Inventory to Ye.in. Gallons . Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY Tank Di 1 ` e Product In full tank(up to fill F�ipe) 3•)/) eneeler SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM Sea manual sections applicable.Check below and record procedure in log(26). Stage I a Water in tank High water table,in tank excavation n LJne(s)being tested with LVLLT ❑Stago 6 TEMPERATUREIVOLUME FACTOR(a)TO TEST THIS TANK Is Today Warmer?❑ Cower?i F Product in Tank F FE.tp Product an Truck_'F Expected Change(.Or-) (617)e32-4216 ,/ 14/z r C, Thermal-Sensor readfrep aftertirdnlallon fro /---•F oW DWM par'IF in range of expected Change �— JIM'S PUMP&TANK SERVICE FEATURING KENT-MOORS TESTING EQUIP. o x -� a , 6 � gallons quantity In coeffldent of expansion for volume chrgs In Oft tank fun tartk(16 or 1T) Nvolved product per'F P.0.BOX 22e G JIM CHASE HARWICH.MA 02645 G 4) 3 + C I This Is . vobrr s change per'F(2e) Olgft per,*F In teat s Volumes per dipk. toot Range(22) Compttb toe d*CkOW Wawa fac'lae(a) HYDROSTATIC flu YDLUYE LOG OF TEST PROCEDURES PRESSURE fO WILUUMM M CHANGES ACUIMIKAiF➢ CONTROL RECDM IE Al CAL Og FACIM W fA01 MAOLNg CHANGE T•epersa re .NO tad notes Snag ee lsvM Pnhd at proem clue. Ceaeandies AlNert Told Let aeaarate IN[ Record details of setting up seafat Iadea Gnw•n R•rlater(-1 TtnraM Rio.. 10^le)- vemne Ia.ra a- read Deets and running test(Use full r BN�N tern n S.a.r L... " III t or I. d at. e tutE length of line if needed.) a .kid. Bat— RAfte, pladed R.aee.d lam) Aiitles Itl IDms caenJ 0a r::.l✓✓ll Reaebe Restated Raedq r]i(Yl—a37(n W r" T 2 r. �d _�. I e cif cal f ' G2-44,11 a,,, : I !'Ste ' '' • `-f [;�I v C f' �°' E: .Cd f� .U$l G • Li!D it I I i I i I I � I i Is. I i c, e-r i f L I ) FORM 77-t000A 1 Data Chart for Tank ystem Tightness Test t , 211pp� 4);- USING KENT-MOORE CORPORATION TANK TIGHTNESS TESTER MODEL 1000 For Packet Copyright©Kent-Moore Corporation 1977 1 ttf SO Chel'tS ? r PLEASE PRINT ; { OiderJ;�'3396-A,p } 1. OWNER Property LJ e'( r 7 dress `Representative Telephone Tanks N ,JG({" h( +-CL C • Name Address Representative Telephone• 1 a: 2. OPERATOR /!� i C.: 4 5 Gr e c �/ 2— •�1 "t_+ Name Address - ,.t Tetephone 5n•^+ 3. REASON,FOR u' TEST (Explain Fully) 4. WHO REQUESTED 1414 1., hl t- TEST AND WHEN Name Title Company or Afllllation Date ` Address Telephone ` `�•{�� 5. WHO IS PAYING Company,Agency or Individual Person Authorizing Title Telephone FOR THIS TEST? r` Billing Address City State Zip Attention of: Order No. Other Instructions Identify by Direction Capacity Brand/Supplier Grade Approx.Age Steel/Fiberglass 6. TANK(S) INVOLVED wf? (? I • Location Cover Fills Vents Siphones Pumps s fr 7. INSTALLATION DATA ,..,: (y to K .' , .t..� i� e ,• r ,,r, h rii.:trt� North Inside driveway, Concrete,Black Top, Size,Titeflllmake,Drop - 1 Suction,Remote r Rear of station,etc. Earth,etc. tubes;Remote Fills Size,Manifolded Which tanksT - Make If known -fir~ l 8. UNDERGROUND ib Is the water over the tank? WATER Doplik4Q44ZZater table ❑ Yes 1:1No { Tanks to be filled Date Arranged by + : 9. FILL-UP —`� Name .- Telephone ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to'pi2Svide?—.,Consider NO Lead. Terminal or other contact \ ? ' for notice or inqui R .r Company Name � Telephone ..u sa. ' 10. CONTRACTOR, MECHANICS, any other contractor involved••• 11. OTHER " INFORMATION OR REMARKS Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during test etc. l Tests were made on the above tank systems in accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness 12. TEST RESULTS Tester Model 1000 as detailed on attached test charts with results as follows: Tank Identification Tight Leakage Indicated Date Tested G ` fel firL� t (� This is to certify that these tank systems were tested on the date(s)shown.Those Indicated as"Tight"meet the criteria established by 13. CERTIFICATION the National Fire Protec Ion Asociation Pamphlet 329. f4*W � y .. �? /YGf�L!►"'"" jf�i� Ri'. V� Testing on ctor or Company., By: Signature Serial No.of Thermal C/!_L Technicians �C Add ress Sensor v 14. W 'I',_e n/ � l� l n� Lea, iI'5�,9�5�� l�C�. 17/D✓ �� Name of Supplier,Owner or Dealer Address No.and Streel(s) City State Date of Test 15. TANK TO TEST 16. CAPACITY From ❑ Station Chart By most accurate 5 o V A Nominal Capacity t,�-D capacity chart available !r ❑ Tank Manufacturer's Chart w Identity by position Gallons Gallons ❑ '1u( Company Engineering Data Is there doubt as to True Capacity? ❑ Charts supplied with TSTT a (J" Brand and Grade See Section"DETERMINING TANK CAPACITY" ❑ Other 0 17. FILL-UP FOR TEST Stick Readings Total Gallons to'/a in. Gallons ea.Reading 0 Stick Water Bottom before re Fill-up I D ar Inventory r to%in. Gallons Do 0 Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY N CD ,r i , Z Tank Diameter 7 X 10 JS Product in full tank(up to fill pipe) 1• U o 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM C ry N r0 F a See manual sections applicable.Check below and record procedure in log(26). ❑ Stage I w A j m ❑ Water in tank ❑ High water table In tank excavation ❑ Line(s)being tested with LVLLT ❑ Stage II WM m n 21. TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK 19. TANK MEASUREMENTS FOR Is TodayWarmer?❑ Colder?El_°F Product in Tank—°F Fill-upProduct on Truck_°F Expected Change( +or- ) , C. TSTT ASSEMBLY O Bottom of tank to Grade* 7.s m m """""'""""" 22. Thermal Sensor reading after circulation S3 °F x Add 30"for 4"L _." digits Nearest m Add 24"for 3"L or air seal ....... " 23. Digits per°F in range of expected change 30 W n digits Total tubing to assemble Approximate ........ ) 3 -4= f _ 03 20. EXTENSION HOSE SETTING 24. �' 0 C x 000 D = C gallons CD total quantity in coefficient of expansion for volume change in this tank Tank top to grade*.................................. .17 full tank(16 or 17) involved product per°F Extend hose on suction tube 6"or more r_ �j e below tank top ..................................... 3 3 " 25. .-tO.D l- s 3 o O = G C I 9 .This is volume change per°F(24) Digits per°F in test Volume change per digit test_ '- If Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) 26, 30. HyonosTATlc 31. 34. 38.NET VOLUME 39. VOLUME MEASUREMENTS M TEMPERATURE COMPENSATION CHANGES ACCUMULATED LOG OF TEST PROCEDURES PRESSURE - CONTROL RECORD •001 GAL USE FACTOR(a) EACH READING CHANGE -, 3 Temperature At ~ 35. 36. 37. x�la.d rttmrn 27. 28. 29. Standpipe level 32. Product in Product Adjustment DATE Record details of settingU in Inches Change (c),(atiod I Total End Deflective p Readitq Graduate Replaced(-) Thermal Higher+ (e)x(a)= yotume Minus - and running test.(Use full Ma, Be innin _,Level to Sensor Lower- Expansion+ At h'"Poo"_ length of line if needed. R g. Expansion(+)or TIME R � ' of which `Before. _Aker '" Product .Reading (c) Contraction- Contraction - �per Noon' (24 MJ �Readinq� 'Restored -Reading' .Reading � - Recovered(+) p33(V)_$37(T) .UIFPA rafbAfI //�� p�•r, 4 44IZ _ ..;tea-3• �} - "t' ^y^W. /dJ. /.. �.,.�._��> G/'s-.„c•.`�,L. -�/ �.J. --.�cx � 1 _-�'�kF-'�``• '� :. -"^--�'i:'� '-'��y ___ _ '-^3'--7�.. i i f FORM 77-1000A Data Chart for Tank System Tightness Test 1.1.2103 64) USING KENT-MOORE CORPORATION TANK TIGHTNESS TESTER MODEL.1000 ForPacket�1i � . Copyright©Kent-Moore Corporation 1977 of 50 Charts r Tk'; PLEASE PRINT Order J 23396-A 1. OWNER Property r r _ / L -,/9 6r ( ) ❑ Name/.a n�I ( dress Representative Telephone Tank s / �l �l T. , Name Address Representative Telephone 2. OPERATOR 4 lef e•c M C Name Address Telephone 3. REASON FOR tri TEST (Explain Fully) 4. WHO REQUESTED 141 -e-Hl 5 r `� / TEST AND WHEN Name Title Company or Affiliation Date Address Telephone 5. WHO IS PAYING Company,Agency or Individual Person Authorizing Title Telephone FOR THIS TEST? Billing Address City state - Zip Attention of: Order No. Other Instructions F Identify by Direction Capacity Brand/Supplier Grade Approx, Age Steel/Fiberglass 6. TANK(S) INVOLVED c4'� �► c - I .• T Location Cover Fills Vents Siphones Pumps 7. INSTALLATION { � DATA North Inside driveway. Concrete,Black Top. Size,TitefilI make,Drop - Suction,Remote, 'r � Rear of station,etc. Earth,etc. tubes,Remote Fills Size,Manlfolded Which tanks 7 Make if known 6. UNDERGROUND Is the water over the tank? WATER Depllhjw4be Water table Yes No k_ Tanks to be filled Date Arranged by 9. FILL-UP �� a_1 Name Telephone ; ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to prdvfd.,1____Consider NO Lead. r Terminal or other contact \ for notice or innui Company Name Telephones 10. CONTRACTOR, MECHANICS, ds any other contractor involved 11. OTHER INFORMATION OR REMARKS Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present 4 during test etc. Tests were made on the above tank systems In accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness 12. TEST RESULTS Tester Model 1000 as detailed on attached test charts with results as follows: r Tank Identification Tight Leakage Indicated Date,Tested <` e ✓/ t c� ,' 1� .a This is to certify that these tank systems were tested on the date(s)shown.Those Indicated as"Tight"meet the criteria established by ' 13. CERTIFICATION the hillonal Fire Protec on Asoclation Pamphlet 329. c p #d� ✓a- / Date - Testing Contr ctor or Company.', By: Signature Serial No.of Thermal Technicians Address Saris& I - r a 14. �/��>�E A/ 1 � i L �� (�U ��.3i .z-S IT,g �,� / [�� . W n1p✓ Name of Supplier,Owner or Dealer Address No.and Street(s) City State Date of Test G 15. TANK TO TEST 16. CAPACITY From y ❑ Station Chart ]� capacity most accurate V,)0 /mil Nominal Capacity 1, L�-� capacity chart available Tank Manufacturer's Chart/+�r�U ❑ Identity by position IGallons Gallons ❑ Company Engineering Data Is there doubt as to True Capacity? ❑ Charts supplied with TSTT Brand and Grade See Section"DETERMINING TANK CAPACITY" ❑ Other --I 17. FILL-UP FOR TEST Stick Readings Total Gallons to t/e in. Gallons ea.Reading Stick Water Bottom O f 7, U �� ,* before Fill-up Inventory r to%in. Gallons 00 0 Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY; QUANTITY (D r ZTank Diameter 7 �r X ! C) 8 Product in full tank(up to fill pipe) D 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM 0o a See manual sections applicable.Check below and record procedure in log(26). ❑ Stage 1 o r ❑ Water in tank High water.table.in tank.excavation ❑ Line(s)being tested with LVLLT ❑ Stage 11 w r - rn > 21. TEMPERATURE/VOLUME FACTOR (a)TO TEST THIS TANK x 19. TANK MEASUREMENTS FOR Is TodayWarmer?El Colder?El_°F Product in Tank—°F Fill-up Product on Truck_°F Expected Change( +or-) o TSTT ASSEMBLY --mC) Bottom of tank to Grade* s)/ "' "' "' 22. Thermal-Sensor reading after circulation 73 °F ZF x < Add 30"for 4"L _" digits Nearest w ri Add 24"for 3"L or air seal ....... 23. Digits per°F in range of expected change 30 W. Total tubing to assemble Approximate ......... 3 " digits -4 ' co 20. EXTENSION HOSE SETTING 24. �' 0 C o x O©l7 _ lG J gallons o total quantity in coefficient of expansion for volume change in this tank Tank top to grade*.................................. 2 7 full tank(16 or 17) involved product per°F Extend hose on suction tube 6"or more > /� e ' below tank top ..................................... 3 J " 25. .lp V s 0 This is f . volume change per°F(24) Digits per°F in test Volume change per digit test If Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) 26 30. HYDROSTATIC 31. 34. 38.NET VOLUME 39. YOLUYO IA TOAOME A (Y) TEMPERATURE COMPENSATION ACCUMULATED _OG OF TEST PROCEDURES PRESSURE RECORD T0..001 GAL USE FACTOR(a) CHANGES CHANGE CONTROL EACH READING " Temperature At N 27. 28. 29. Standpipe Level 32. Product in Product 35. 36. 37. tdl t.ral record in Inches Change Computation Adjustment Total End Deflection DATE Record details of setting up RaattieA Graduate Replaced(—) Thermal Higher+ (c)x(a)= Volume Minus and running test.(Use full Beginning Lavelle Sensor Lower- Expansion+ Expansion(+)or At Low timill t omtwo t TIrE length of line if needed.) of which Before After Product .Reading (c) Contraction- Contraction(-) Phillips par NO" i - - Reading Restored Reading Reading Hacorered(+) #33(V)-.#37(T) OEM ORIaria) - (24 hr.) _ , ,� A A d f } ` '� a; q ► v � Q :ram ,:� � � ` � q `� �s. .. 1 � Nr iA 1t •� I,^ a 7 1 i� - k . .1 S *rf. f•_ .yL 3f, r.. . 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"�:S„ n.t:.:, ""., - s-�5.` .1`•�'73 �' 11.e' r .fi. ? fi mot' _.�4 e*f t ,,..i r �. e",f .� k d -',a r` .. r :y7 I� � .F ,a u�� a 7"kl�t ~, ,` a.,anti• ., + tip., s 4 * et ,' v:t, ki'".1c, .}` �,T1Qlla �t _ 11' Tv '`3r r,. k ." 'h.,, �S 4V aiM1r ti �_ Iw 1 .I fi F At t r ; ` ger -p M r j, .,,. =i ,A.. .� tI{ j,.;j ! .,r'• ".+.. 'sa #' s,4 r� ^ .1v G. i tt �•`; 1+' .kr 4. ..k s.r i ,f {n.y a 17 ar �+8�'. uZ A� 13[.• �t ,.r '2 tt f ^ 1 4;•'^'sY„4 Srcr`4"I. a .a t r• r s. wl .,.L ,,s «{ ,� v i � `° 'bf� r Barnstal�I "Roa -'III r .I � >x,?•�rj; tQ.r .� ( .k "_-4 + Y�• -1- !f a r,r f " t,''a k '. ,�y' �j r!: � 4 d Z!"'T4 .•,,=r tt?'- t - * z -, �f C A+� .c!♦ �'', ',,,, I'"'�'� ,•SJ `}4h"t•�.a +.y{ `r `� a t Y , '. I , �' `' 4•}, �Y'_ ?�t�t�"�' ¢ as,.t. ",�e�r .. Hyann. 1 t i',4,*Se,.-V V.1� r k. �!, } Fh,+ �Y ,1!:t z r,',-�;,-�. a�I.1.t•.-,,,+,,,1.�,.;; K e,, r ^ +i r•' t, ' s r ,a r ,yc. ".d yJL.:{S ,�.;. t, p�,� t • r.y .. t -,. ta.' ril 'x ,,�..,,..' ti r i`,. c �•` h �"'tl w p 'r,.: �� `,r L,.f., n .�.,.r.. � 'did. k fib w a akuA,rtJ_�.. ✓ ! {,' ` a f r.l § -f r w r 1 i *ap, ?.v . r s +r ,.. �'t 4 < r y x•t ti ,pit+ E:•,'4• iiir `uftdQI'C �' 12�d� ile�.� tSl11a 'S -, It rr,1 �$ "z Imo+ ,y.4R 4 ..�, yF y s + ` a'a t vx . .7 4 4 .�-1 ice+ `N lE !+ 7 :fir. ['.. 7 c,x; 4 `g 4iK ,{�. `.. 11 a w_. Si-'Z .•.. :.,_. :...r .y,,,.. ,r+ - �� i r"- t} 7 ':r �w<r r z z +`t 7 c. �.[•t 4 r i r k r ;. x a -.i r� + x ?r ' t .-t ,�i aF v_ 3 r1.e -(' ..✓s V •'6s }`•.y; b,3 �, k✓'ir, s,,y , .• ,�. ��t+'�'�• rP'�' r°�'.� s t , r •y w 3 11 t• '.r`s`',•n rMrr' r `"Y"^x} ',?.i,:.•.. 4.7't i` Li, �4 '• ` ,'`'€� v' T� s s , "- , `Y r 4q f v l`` t �r,,�"`.„ �r•,.016.Fi 1p i.r 4'7 r s is 'Zt "� ,,.+,,. .' * `.r e„F ,e� r'r,,.,44 '� ix!t7 n�, i a i, y . ^a .r ,q". - •, �x -„;s Z `a 1.,it�fi r a,�' ,� .{'° ,3 +' 'j7 , t. .%r.r '• ;,.,C - F 1., + •; t s' 3- t' r 7''• k, `r aY * ^ 1 r t� r*Xt�ut�ax e�r�nyt�.nc�ied i lea ul'It�erg�'ot1XYd,fue3,�,,ks� ,twenty yea -s k of, age � 11 � c, � , r,x '*`r', r,r€,, -i -o1de"i 7 .L 13, -"jiaLyo,"a w8a?�C`r �*� {)f oVE$rr 5'i7f ( r3 . .O1 S IttttSt be �te.ated ;` '° ,l i t �- a .? � c i' year "for gaks':5,t ;' 'e`l�ressu a Test A�.s'. the'; re- - �sI , � t' , �� ,east Moo P , r ti "' r fame_ test hbw ver aria 4*i tank .be `tested ' , :, I. l ;. ' . fan tb {a 5 PSZ- Air ` , �: Pr:essure�:hest tiel for mi. uinf of tWo6. our `. :TM�e r='Pressure Y ,�_•,.r 4, x , �,_�": ;fiest;wea `only='bex;d nekon;an ein ty tan'kC aha�� "'nat the pre'fer'red .d ,f ti.. v" 3 , r �� .r t .' .1 ti ,� e� �: t ` `Wyj{,_ .,r,�"si�'rt a'"..•,. �L.Gst.re ° i i`F'U..� 3�iy�,5 ,.,++ `3' .t 5(�,_.r3��.;. +y�:.,�,y t.f'.i+.n `,ri'.; r3>FSa,ta '",r,.: S wr ...ra `y-x..�, '�„' `, t' i"'"� S ''�p"r�....' �.. , .«, r - a " ! ♦ t j,. k - X ,, .�'y. `"S� k> ♦, ^-. t i, s. Xq`7r,y es i` -S,"�ye t+`s �`f 4•t'�' .;r•� we G. cY: t• v 7t `i "k e c tr 'qm'` �' v. C:. i v4 ti a-:, �•k,,,,'t'tt ' + '4c.:, ~'s' y 1 '.. ' h .,f R tom.. S r. ., �. s: N '�. {.. X {n r i "``' ., `', #Y6iir to x��=fc�rt�r_tine y��`rs�old cod,Mas tested on ,AtkJuStt,13l • r � 4 , fp % ? l9$2 y •x s � a ,J r 1 ? T�y�,g,.0 c r•- +' t'.rFNr,} . kr�i 2'i ash ,f i{�If �� r it r{ '`h rr+lk' *h E'.r d„aFI '� r4K° 4 lei.- .,; t;� AM � � , »t el:�:,tiJ; �I, d i. yt' a .�..4 •w- ': a' tik.•., ,, 3 w-- Af• . 4't e,,dN { •• t h r :hv % *:t;_, wy.�} t .,, i'• •' de'"i'tT. v's Y ` r '' s ,', You area° erected to; ag x�z�have et�e t4nks estd(f y fovember 3 ! ,;se ' . s �r ,� :. ,`~i983 :,and =�s- cb sy, of the,results{.tnlist* 'be 'sent.^to thus' office g aId", `'�� .•t r j p t . t s�a.k L r +s '.:r xr _ s r a r"w f 'k' `• r° �i�S- a4, , ,p".. ,z . C t0 N©vembe`r' l•,t. rF i, " ,.� ,,,t � +'° ,e. t �,,r 1,�_4 ., 4 e ,.k - ,:`K 1 r,-s. I y" � z' 1 y`� 'c 'i v ._ y+, c - y t ?,^ �. ,"[.1. Y€7 t r 'r S t i ,d '7 Y ,•. va,;r,.s r •"' a;.y 3 r 'f, "r t r �t~,s,* ,,.,. $< `�t s�,..v i K .,F' �^ 2`+.Fe„.� �{ ? j3et rt+'k„y a 4 4. ,:: s F; t ti •'t "' °'4'6s�.y w, "'0.'"',,.r lea1�1 'C k teste du .c3` sul E'�r ';1.r z : lure ,�to;_have t2ae..#tan ,, d.,, r ' if"L,.a f ine of:•not mQr�e. ' y : . r. than $24�.t � ach ,separate �c3ay�s .`f nitre :to coitply withi an order . R= \ 3� �` ; r4. u._ f ..... t.. • y i. € I ,{r,r. v,`+-d't'� -,� " T r + ' A_: s. i+,v ' ` W P !n. � �' ;, 4shall constitute' a�;separate vJ63 ati n.4 z ,:,_ , . r W�."r •t �k { .!. '•, {t, .., }}:t V•4 LJ., +` .k,{•V r' y=! tt t .�F t'.•c. _t .X s r I. ., t.t RL ,h + , tr , •- ,� t ,4t r�� _�t f 5 ?J� , nw• wti ..SL�7 w 3. 'xx..�+rtf+a'$.t{ig,•„7i. ?,a!° r 'mot xx,,: ,,ar.. ,a„-�.' f,a. a+ t:; s 9t ..r.q 4 L•. s '• . She would 4pprecaate: your�cacip�r t��r .g5,n`:thls muter=sar.v'�.yt l*tto {►: , ` ; � ; t ` �� 'PU L Jc safety]ani3` the grater'• tal�ty;'of the�t kh t Y `� r'x >. � � ,r w 4 ! ,t,:et F ,.� x. �' i, 1 �,', V �S w rr t ,, T -4: ,. ds .t•�,. It 1 1 `7 >' ''^ � i".� w i`Ex ,.Trr p`N - 4"`- �r !�M S,l^t lam' 4t.r�.'� A 4.ttk r.'c, �}bt1 ;L�s ttet.++�r,��, •�.. ,, !, •��.t T,'' "+,''��j♦ ."�.i s• xj S v,c .�zp•�.t�4 I I+.7�t 4,, , •` ^ 1 'rw.:,it '� X .Q.4,t 1, I -<I .1 ec l I.f,• �{K avG-.s6 y, s,�questi�ii#7�,�,e..,:I 1-�'"�'i.M��-.- "�tsi�+q l.V 3a LS3¢• � 1s'f° .4 +- ! T ti ,_? {ti t14 s. : I ,y ! r� ■ '1 s c�,� a r r 4✓ i-�4 � •_ _. `$ { f' R ,k,,,`"a• ^mot r'. ?'� t, I, i } 'a 11 t .,r ., .:' +tp 'K `' .'!+ 4 l `�'S. 8.r + -M' .. '3 , ry -� }V ,r- ria �, +? , k-,rb j t.;;. , l ; ve i t our n�"3 `'' tr u•' v. y...,`{ - 4 _.� I, e s c ti �: x.1,,..t . F a S. "'.l '• 7 .�. .By, t.�- 1 57 r s i,., 3 tf w t a ,sTitl ,`. ,, z,u r:' .� t t yf....: 't. 7 ..a f ' " - t' ,',' s x r .,. " - r t 7 Z {3_. •t x r - a r'# �, :y , a r/ ,I z v'� i '': I,4 rf, S, a t + tt: c',. t t� r a r�, x.: j� -•E j 6 ,. {1w' s e, ja�" 11 t .•7 why "'? "` .f4 'A ahFa �4lr�° r- �_t± f, r, .� t ,t '•;�'» ,° +Fa y,_a „, .V t '..4- F x .I ` ,. r t:. . .� 'F.:' t. + ♦a *, e r + w 7�R'3?,+„ti`° U tjry, iRo rt`L :. i ds :;Chairman �'; `e ,I pp" YM bb x. " , 'I Y r ,l:ft ' i 1 ¢ r �' c ..{ , ''f' �-7$. i t r b a; ',f'�tCNF, t F a � x r r a n` l �. •. I{,.t)rtM t....�,f �,r .1 I (� j.' ;} +^ r ,Z~ j r, *,,t,�v _;�. w �. y a '.t t�'h r ,t' t A T i 1 . ., �, ,' I a `"",_ .� f Lam. 1 41 L`^_' 3:-, f �+`- 1. �, •�tY > u,, M 7?.�..,,,, y, S 3 ;r, r 1` ��w 'N , ;+ t`�`,yC Anti Lane -�' c'll,ig�i .'.,. t 3 t j` �L.i` t+✓ .6 rr 'I. e 4* t Y,�, ' r`y i ,..$ t'+, ';`t s I. .z ,V'"L.. 4r t r r, r t t ,�, `: +.• 3 r s 6 F �4 - t I.tt w •1. K 1' 4 .{'` 4" ^rY•°* 11- ., F �-i� l W 1. S * t,.'.t r{.,�,. s ,S+ ° ,�! •'C...✓ ° +a rr. •Wr ,- r.4. a<" '� <s: ., 4`1. r, t ;V 4i ,T`' 1 A f :L Ta y1 - Ty !' , t t a e� .`k R r �t , ^'n t ^I'ip1/f•�+7��l��TTi shy♦gP..�' ► ]JJ• , I ?t,, e ? c..t - <.L. r t.. ' �� ' `< 4" 'r:fit I .,' O .. t a „ t -, �,: , t• - 'r ,7' z ,t• I, ♦ ;^c`kf ..: ! '.::a. f t•- ,4,' ..k a °- ;, - ,eo - + ..t '. V.r n 's } : �,.} x' r 4 ;7 '�, t 1�. , - , gi'•,,I + s _�• a lr s_." �'x j L. +•r f j a•Y ', z ^,.z ..s,•' f ��.�"44 ?r y+' YY,I. a�aqt r2 _,. t , I. ,t4. " ti "i.'' ,- r -t r+ 4S . S t+ , t � r Fri . t 'R _ �.` mat t , 2 :'S .. r �e'S: d`r 'Je -xS My wb.'• 6 t, 3+ t4` j tr.y 7 �'{, • �. ,-I, , r ~� :t ' ;r '` YSi !,L 4fi iRr^fj j � y '; r• - r 'a• � w .�. r S- �� f .r d r r,ta l ' A'•' �' 'r a� �a �ti. ` r, kil+ � ' �, t, r y ,:'v .f r �':. a tit. a•4• ! ' f 5* �ti •� 4 `� t �+ f• /♦ ; ;- '. ! ` .'Y. d� ,,y .y�! r •.', a t a r Aay n t• r�' `� to i $,a o t„r, V t s 4't'1` -r 4 r N'l ; 7,F •[ r 'P'„ +., '.: � ;yi , ' 3 + y 4 s a a i � i. ', r_ 7 ✓ 3' + !�' 3 •-i'x }f. � r- +L �� s't'i - + f.1*; `� t 5•.+�J•y..a ,�';'! {r•N�pf � ,' ! �,! ''N_;'.`� Z�_] "�.e t;� y r •-.R t � rk 3 4 • a� �r-. .f� �' r i +' G e.4h ,} ,s-`3a ti.r� r .: !r :. '� se ' �''4,r��`$',f 4 _'.. � '�" :*:'s G,. v+. j a rF _.,:.- "• ± y'++.�'' y� �a .., r a S e � f �� 7k C r.,,t,R t •a - ''�' t t ' ',y {'.ir �t- r �• t .,..r�'' r t ' a '• � +`� t ,+'' -Sr' .� ! s w `�' a _•' . �i J '� 1; !,r•, �" -S v -.rr •. t e S r, •� � r r- r _ `' '✓�,?1 {.iv A i , � Y F + es z .�" 4 � Re 9 } $ � �,a�• 1r, a.s a# r t:[�?" cy �i t n*t �w ,, •i r �,,.: a�y,f �yrr R ;�'�,� � t�? •.f�, f �1 � 't"a?,r 8 e 7 Ca '�'�, rAugust 119 1982 !: �:`+ ,tab'•* r fF a �^AYE ,•c h. s {.,� � � rat .aJ e •a ..t � .. r ♦a`£ � �+..is i t '� F'�•. '"i•�� arze :r � ,a 1:3 � ��.� -'r�pri $§s• n' " �y �a' +'.• J w'}..'dy' fiA,� �.,IS }i t^r's nt".' rf� i'krF�`..,h � b,� �. ` +y =at' y 6 4 a t Y L;•+�{ t' . i J,_yhw4. ! ,i. # #+, •n, w Y- Y e r .ft •,r s c 1 �. - lj e i 1 -.Sj'`.}�, t •t'• i t r ti ._ �' [ �a jrry•..tea. ?. ..� t. * n F t° �« +•a„: i r.. ! •,, � 'k.. . > _ .�w r n # .•Za{.,"L=:j,v_+-�_a r �':;�,k.��x' r•;';', P •',i�. ."� 4 ti i f•ia....s`.tir.a,>�r,t�,rr <Y`_� f E'a t F ',�x'.,'s�^':'''c'.t�. } # Mana :S•• ,*a-_.y•'.'c rk Warren Buick; Inc ! stable Road >'y A'r1 z4<..fyti4`r s�!'r-">'Fao. c.>ti S rs�F�� r74r'i�}i.•.:,. 100Barn r `•. a warr _ti r.•u-x,rt r c. ' a " Hyannis j Ma- - £� .r?'ac^+'�i .•i'�. *r_O.s J', }•.•c tcr,; < .�., �'_y r`,�. t,-�o 'S� a;w a^ " J• •;�, 4, , ,a 4 �'' irr' #. tAl o Y ?. y.,; .-0k r ;a-`' #t�f4�'!{ - y,« `.t}' • d$gyp ..r s>' } t 'I $• r .ir. '°y + Dear{S�..r k. 'r a +- t .. i42 +r. r :i e :k ya r 1°k ,,'?<"t' t kfti ;1 S F ,a ,,i. _ c d 4,�tT ? r '-•F .�:'j � s•fiY t�?.f• c� 1'�� :4 '��,7 'S'- ,r ..r '!µ' ''�� +A t;;-d, � ��y-:}a � y�-6'•.'� j A a� `•- ,' ,�4 at Underground fuel tanks,�twenty years 'o1'd that haves a 'capacity of.,over-'500 gal lolls'must' be ;tested each yearn for leafs The Kent "Moores Pressure 'Test is the 41 R A a�}• .+, tin. ,. • -:- 4..:•/ preferred test, :however an';empty a tank',can�bey tested, by ja t 5 PSI.'Air'# Pressure � •� � f 9 Y fi - j!` .f<:f q S't •� ,' Test held-fort a min'imum,of two. liours�. The Air iPressure Nest .can ;only one . , r r oSA 711 n •an-an .i3 not ;the'.prgferred.,test,., a a~ ' ` '`ems �� •.L �i'a s'..'• a :u '+� •�.' #„ ,.. 5 ' �i * '� f.'.� r 2 � a`• � ,.i. '' � .� 'ar• � t.� t .a > :. .x t!'..1 f: � ,?. ,� e•4 z J�#F # �` Y• � , ' i <�•One-of your°•tankstis.forty,years old and wasatested on�November 6;�1980. ,�f � ti' 4, #• y You are directed to•Have the ' x a , , '# ;c s ;$tank tested,by October�15 ; 1982 and'a copy« of }i the results 'must be sent to. the' Health;Department' " •;x "" r', .�'� i.-" a ry. 4 _ -•_t r "r � ♦ - C L .'� s,..at4 r `} y.- rt :luie^;to tlevetiith6 tank tested could result in a fine of not more than $200. C art •.K:,mac ,• •�„� t:e •- ,�- v. F".3�}-. ,.. ' Each'separate day!s ,fai lure'to comply,with-'an order shall constitute a separate'. a `violation. r : .f y t a .. v •}; , a1 c ,,, A ..- .Y as r' t: p ;: ! '.. ,.0 �.. v ';. s :M l ' We;,would"appreciatie'S cooperation.in• this matter so vital to the-,water. ,r '�' a >, ,,,•.,.-.. •r ,, tr. � 1 „rs ^„mow• f sh.r a' quill ty.=of the town.. �. r R•.t" „ , r �" 3 a r J , ' °. „e :x c r } i - ° S.,:• r '' M� _ & , a rr t fir,•. y 4a. +k 4. J.,• y,.ra �;a r t!, S, � � s . �� `'; is n � r••t��xa'. � •' r.�` E •+ f°., �•. ..�V r yC•� `Ss Please call -if you:, ave any questions 775-1i20 ; extension, # • s � >; T •'•k W t •r' � r � � F r -,. +�,,_-1 a <ef � M t j ,z` }t ! r, i 't.!ry g t ya.+, ' r 4�'Y.t p ' •' a i••a 2 1 tilrti�r # _ r r„ t t7,r•f ... Y ••. a . - r v»r� p.•t rk i.',wf Ve truly yours r S`€ st .h ° r^-3 •a .4 r� ^.' ,:r e, t eS sr .•. :;, f`t ._a * y � w +•� e .� ,. Y rt ,., c^" ' f ? � '� •5 7 "{, 0 �, ,. � r a _ !. fa " '. ., ° cJt4 �{ r4 r ,3 .. ��,. fir. w L' f 'Js�� •'ih ty,�r'K"'1 ki ,fir.;,Y r`ra� �,. + ,,` {:; �� t t �e�t.•;�: � 'Y� �, �y r ' t ^ A�''k' a l?ert L Childs, Chairman � +, *.: .� -0'c*„ ^a �,� a .fit a .r s. .• 3 �4 S t ?- f ...k..• w • -v � �' s,•� S,a�"t. t� --- r r..t `+r r #C .. a rr+�''S =�,;`a�r �-a .J .� , - `"S7•�. a tE r � S �'`' r J• e s!., � • }.n. r. y' h*• # #_: - b T anti i +Y y k y�..,a ~�,L t _ r c •�, ..ti, t F s. � a �� •- • • i `,5 - .- '�'� } of"`f4 'Ann Ja�$hliaugh+rat et w i *Ef.�Y lk +c _- > s +. 4. r t >r Cal] i s Jt `.�r•1:l 1 i�r• f. .•w . .1 r � �Y •-, ,. i '� -� t°i - a •�`=p v 7 r^:y`' a ,+ . r y7 0.!r t '•_. J r k a a t ♦ 1 r. .r• ` , { {y✓., . i L•"�eYs AJ'F' 4 1 , �t ,, �* f 4 r >� H ,;F• ng i D� i + r 1 { �. at ; c� ,..� i r. hip BOARD OF' TH s t r? ,y. � a �. • ; a �* ?y - r we �' '�•, t,.1. , •TOWN •OF, STABLE, .: e .� a+.'z A.G rr r e _ ° * •*{ A,.;; <t f '' -• a � ?`5t - ' � ! � Y� � .• f x �J f c:w "t .Y,_. 3 :r� m {` ', J +"", t�.� l r a i •„ JMK •' • . ^'3al •R�� of 4•t•• J• as Y # ' V•.a='••.�•• f � d ti a..fi:�Y • 4.4- +' wJ '+'-3> j. �. t j '•i rr j a • - f _J• ', '� ,: 't��"" i' 'y t. ,1, ^r. yr -t J r ' t .. �.krr�.'#. ;v � i� Sj•' ! .. _.` <' y r d. s a A <J.r.. ''�• }. f..- A �rp>S ah < _ i` % n ;K - f - •� � •<`.• h - �� y♦ t r "ti n r••y�r Ta ',`,4/�'�y •>'�i� ,av` ,.r � q,. • y ,. •n• •+, _ rf ti_ !•.r ,a .a � .S �. } R� S. Russell . '�►'� Commissioner J Paul T. Anderson , C,9Y46- Re_gional Environmental Engineer e , April 2, 1986 Warren Buick, Inc. RE: BARNSTABLE--Incident Response 100 Barnstable' Road Plan Approval, Gasoline Recovery Hyannis, Massachusetts 02601 and Groundwater Treatment System Warren Buick, Inc. , 100 Barnstable ATTENTION: Rick Richards Road, M.G.L. , Chapter 21E Gentlemen: The Department of Environmental Quality Engineering has received a report titled: " Gasoline Recovery and Groundwater Treatment System Design Prepared for: Warren Buick, Inc. Hyannis, Mass. Prepared by: Goldberg-Zoino & Associates, Inc. Newton Upper Falls, Mass. December 1985; File No. A-7171 " This report details the subsurface investigations conducted subsequent to the discovery and removal of a leaking 1,000 gallon underground gasoline tank. A total of nine (9) groundwater observation wells located on the property indicated the presence of free-floating gasoline in the three (3) observation wells located closest to the 'abandoned tank. Estimates of product quantities required to be recovered are approximately 1,000 to 1,200 gallons. Groundwater samples collected for dissolved gasoline component analysis from site monitoring wells revealed BTX concentrations ranging from .04 ppm to 131.7 ppm. •" Site remedial activities recommended include the installation of a large diameter (30") recovery well with a two pump recovery system. Contaminated groundwater, pumped to establish a product capture zone, shall be treated for removal of volatile contaminants by passing through a counter current aeration tower. Discharge of treated groundwater shall be to the ground on site via a precast concrete recharge pit. • - 2 - This office has been notified that Warren Buick, Inc. , intends to contract with Zecco, Inc. , to install the gasoline recovery and groundwater treatment system with the following design modifications: 1. The 48" concrete well vault will not be used to house well head and recovery system controllers below grade; 2. The 8' x 10' bermed concrete pad to serve as base for product recovery tank shall be eliminated; 3. The 1,000 gallon precast concrete batch feed tank for storage of contaminated groundwater prior to treatment shall be eliminated; 4. Groundwater, after being passed through the aeration tower, shall be discharged to the ground via a precast concrete recharge pit. *; This office has reviewed the above-mentioned report and approves of the design and construction of the gasoline recovery and groundwater treatment systems, including the requested modifications. This approval is given pursuant to Massachusetts General Laws, Chapter 21E, Section 6, subject to the following conditions, as stated in the report: 1. During system start-up, effluent samples will be obtained and screened for VOC's daily for five (5) days. All data shall be submitted to this office for review. 2. Thereafter, bi-weekly samples of air-strip column influent and effluent will be collected and screened for VOC, with monthly confirmation analysis by EPA Method 602, for the duration of the project. You. are also required to provide this office with monthly progress reports on the status of site remedial activities. Included in these reports shall be data on: 1. Groundwater elevation and apparent petroleum thickness in all monitoring wells on-site. 2. Total volume of product recovered during the previous month and total to date. 3. Results of monthly sampling and analysis of the influent and effluent . to the air-strip column. Every third monthly monitoring report shall include a current groundwater contour map of the site and a plan showing apparent product thickness and locations. Please be advised that this. approval pertains only to the design, construction and operation of a gasoline recovery and groundwater treatment system necessary to conduct remedial actions required under Massachusetts General Laws, Chapter 21E. • - 3 - Associated discharges of treated water to the ground and volatile organic contaminants to the air must be permitted in accordance with 314 CMR 5.03 and 310 CMR 7.02, respectively. Cessation of recovery efforts and treatment of groundwater may be discontinued only upon authorization by the Department. Should you have any questions concerning this matter, please contact Richard Packard of this office. Very truly yours, Christopher Tilden, P.E. Acting Deputy Regional Environmental Engineer T/RFP/kd cc: Zecco, Inc. 345 West Main St. Northboro, Mass. 01532 ATTN: Tony Zecco (Enclosure) John Kelley, Health Agent Board of Health Town Hall Main St. Hyannis, Mass. 02601 Barnstable Fire Dept. 93 High School Road Ext. Hyannis, Mass. 02601 ATTN: Chief Richard Farrenkoff Div. of Water Pollution Control ATTN: Philip S. Ripa Div. of Air Quality Control ATTN: Vaughan M. Steeves Office of Incident Response Boston, Mass. WARI INC. 1,00 Barnstable Rd, HyanniS -------- — - -- "-- -413 F{ f i{ ft*f�f#�f�fttffHHtfttHEftfftff #t# # tffff�Ft�Ft#ff PROFILE OF RELEASES IN BARNSTABLE 4 HAZARDOUS MATERIALS RELEASES BP STATION 230 IYANOUGH RD. STATUS: PHASE 1 SOURCE: STATE FILES FIRST LISTED AS TBI ON 07/15/87 SITE DISPOSTION: CONFIRMED PETROLEUM RELEASES BARNSTABLE FIRE TRAINING MARY DUNN RD. STATUS: PHASE 2 ACTIONS BY: RESPONSIBLE PARTY HYANNIS MOBILE SERV. STA. RTE 132 STATUS: PHASE 3 ACTIONS BY: RESPONSIBLE PARTY OLD COLONY STATION 258 IYANOUGH RD. STATUE: PHASE 3 ACTIONS BY: RESPONSIBLE PARTY WARREN BUICK 100 BARNSTABLE RD. HYANNIS STATUS: 4 ACTIN BY: RESPONSIBLE PARTY NITIAL REMEDIAL MARES HAVE BEEN TAKEN. REMEDIAL ACTIONS RESPONSE CODES: A--SOURCE REMOVAL; B=CAPPING/FENCING; C=GROUNDWATER/SOIL TREATMENT; D--MONITORING; E=OTHER CUNMID GOLF COURSE MARSTON LANE STATUS: A REMO:DIAL ACTION HAS BEEN COMPLETED: RESPONSE CODE: A ACTIONS BY: RESPONSIBLE PARTY FIRST LISTED AS REMEDIAL ON 94/15/87 PURITAN PONTIAC 460 YARMOUTH RD. STATUS: REMEDIAL FIRST LISTED AS TBI ON 01/15/87 SITE DISPOSTION: REMEDIAL LOCATIONS TO BE INVESTIGATED MOTE THAT THESE SITES MAY OR MAY NOT fEGUIRE REMEDIAL ACTIONS LISTING HERE DOES NOT INFER THAT A HAZARD EXISTS AT THESE LOCATIONS: BARNSTABLE LANDFILL SW FLINT ST.OLD BARNSTABLE STATUS: LOCATION TO BE INVESTIGATED SOURCE: EPA CERCLIS DATA BASE FIRST LISTED AS TBI ON 91/15/87 SITE DISPOSTION: SI PAGE 1 BARNSTABLE CONTINUED BRADLEY'S DRY CLEANER 242 MAIN ST. STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 01/15/88 CHEVRON GULF FACILITY 725 MAIN ST. STATUS: LOCATION TO BE INVESTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 04/15/87 CYRUS REALTY TRUST 157 AIRPORT RD. STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 07/15/87 PROPERTY 5 CHARLES ST. STATUS: LOCATION TO BE INVESTIGATED SOURCE: STATE FILES . FIRST LISTED AS TBI ON 67/15/87 PROPERTY 24 SIT RD. STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 91/15/88 PROPERTY 599 IYANOUGH RD. STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 01/15/88 PROPERTY 619 MAIN ST. STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 01/15/88 THE STRAIGHT {AY STRAIGHT WAY STATUS: LOCATION TO BE INSTIGATED SOURCE: STATE FILES FIRST LISTED AS TBI ON 01/15/87 DELETED LOCATIONS LISTING HERE MEANS THAT INFORMATION EXISTS WHICH INDICATES NO FURTHER INSTIGATION IS WARRANTED CAPE REGENCY NURSING HOME 120 S. MAIN ST. (CENTERVL) STATUS: DELETED SOURCE: STATE FILES FIRST LISTED AS TBI ON 64/15/87 SITE DISPOSTION: DELETED PROPERTY 749 MAIN ST. STATUS: DELETED SOURCE: STATE FILES FIRST LISTED AS TBI ON 04/15/87 SITE DISPOSTION: DELETED PROPERTY (DUPLICATE) RTE 28 STATUS: DELETED SOURCE: EPA CERCLIS DATA BAR FIRST LISTED AS TBI ON 64/15/87 SITE DISPOSTION: DELETED PAGE 2