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HomeMy WebLinkAbout0242 BARNSTABLE ROAD - HAZMAT 3arr)�;�Laz- IME*ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARM SS. 200 Main Street• Hyannis, MA 0260.1 W t6M 6�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 MA'S Business Name: Date: Location/Mailing Address: Contact Name/Phone: SN- 77vr_ 9119 Inventory Total Amount: MS License#: I� Tier II : INC) Labeling: Spill Plan: Oil/WaterSeparator: I Floor Drains: O Emergency Numbers: Storage Areas/Tanks: o 2 VIAWe Emergency%Containment E ui ment: f C ;n Waste Generator ID: Cl 2 Waste Product: br'1 Date&Amount of Last Shi ment/Fre uenc Licensed Waste Hauler&Destination: P S -11 i M c� Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS V)d G�0.(l �n 'M\WA-L. NOTE: Under the provisions of Ch. 111, Section 31, of the Gene al Laws of MA, haz9 rdous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: A Inspector: i Facility Representative: an hover (ram 1VA WHITE COPY--HEALTH DEPARTMENT/CANARY COPY- BUSINESS • • Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners ................................................................................................................................. 242 Barnstable Rd., Hyannis, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons 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 bl - Town of Barnstable Inspectional Services BARNS LE �•T R P.411y BtE•(ENalwLLf•[OIUff—ANX15 Public Health Division SX113.639-2Ic•:.ES BfW STAe:E 1639AIr0�14 eDL,L BARNSTAB M Thomas McKean, Director MAJUL o!yg.,. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 "E:LAI1T 111 - 499 Gallons: a 125,00 vv CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ a-�v *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. —31a: u A 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 MATERIAL/STORAGE/USE TORAGE/USE OF . GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? �' YES NO. 4. FULL NAME OF APPLICANT: D.e P1T11 fT� _ 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: we r� . t o Q� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: / ' S- 9. EMAIL ADDRESS: 1 c,� C gfg'ct)^�� . r 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, T�PHONE#OF: CORPORATIO NAME PRESIDENT I n G TREASURE n► �d S CLERK A GCl't1' 12. IF PREPARED BY OUTSIDE PARTY: NAME: ' TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx Town of Barnstable Inspectional Services BARNSTABLE W11STe E- MF MU-Cowa-4M1N15 1441 RS N B.�N'1L5.OS'ERYRti•'t."_ST MME Public Health Division =6 -2014 "s BARNgrABLF. Thomas McKean, DirectorMASK 1639. s` 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ' T: APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS cr'r 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 ❑ CATEGOR` 2 'E Rr?9aFT 111 -499 Gallons: $125,00 /15-r CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ � a.vb *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? V YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALSTORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(2`5 GALLONS)? " YES NO. 4. FULL NAME OF APPLICANT:. T.P ► i 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: Bq-� �' �� - ntj� M14-- a zt.Q 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: L d2 9. EMAIL ADDRESS: �' w- �e �� 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, T LEPHONE#OF: CORPORATIO NAME' s' PRESIDENT I enno TREASURE k?- n%'5 .S CLERKKke0KOS 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATEo Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx s A Tripp,Vanessa rom: Tripp,Vanessa Sent: Thursday,July 23, 2020 3:01 PM To: 'spartancleanerscapecod@yahoo.com' Subject: FW: Haz Mat Renewal Application - Need Signature Attachments: Spartan Cleaners.pdf Hello, I am following up on your application. Please see attached application submitted, sign, and return to me by email or mail to 200 Main Street, Hyannis, MA 02601. If you have any questions, contact the Health Division at 508-862-4644. Thank you, Vanessa From: Tripp,Vanessa Sent: Wednesday, June 17, 2020 9:50 AM To: 'spartancleanerscapecod@yahoo.com' Subject: Haz Mat Renewal Application - Need Signature Good Morning, 4 hank you for submitting your application. I have attached your application. Please sign the bottom and return to me. If 1ou have any questions, please let me know. Thank you, Vanessa Tripp Town of Barnstable Public Health Division 200 Main Street H annis,MA 02601 a� '['he information contained in.this electronic transmission("e-mail"},including any attachment(the"Info.rmation"),maybe confidential or otherwise exempt from.disclosure.It is for the addressee only."I"his Information.may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature.As such,it is for internal use only.The Information may not be disclosed NVIthout the prior written consent of the Director of public Health and/or the 'I'own Attorney's Office of th.e"Town of Barnstable. If you have received this e-mail by mistake,please notifl-the sender and delete it from your system.Please do not cope or forward.it.'Thank you for your cooperation. 1 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers 0 satisfactory BOARD OF HEALTH 3.Auto Body Shops f j , O unsatisfactory- 4.Manufacturers COMPANY, r ` CJ` ,( (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS %ti'�-� / `. ,'�'�f��i�/ .( �l� J J 7.Miscellaneous Class• y , \//'4,1VPV 1 J QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALSCase lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: � DISPOSAURECLAMATION REMARKS: _ r 1. Sanitary Sewage 2. Water Supply 1 r-� •+ - 1. 0-Town Sewer O�Public 3 ` r EO,,On-site OPrivate ' 3. Indoor Floor Drains YES NO I k O Holding tank:MDC f � O Catch basin/Dry well a 1� O On-site system i 1 ! l Z 4. Outdoor Surface drains:YES NO -OR-DERS:- O Holding tank:MDC O Catch basin/Dry well O On-site system 17 5.Waste Transporter Name of Hauler Destination Waste Product t YES' NO NO 2. Person (s) Interviewed Inspector ' ' Date L /J • • 'NCE: CLASS: 1. Marine,Gas Stations, ' Suppliersep 2.Printers OFAMON! satisfactory 3.Auto Body Shops AN unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores 6.Fuel 7.Miscellaneous Case lots Drums Above Tanks Underground Tanks Mof • . 1 1 1 • '%i • • ��%�_� _ r_'�i!_� �ram/' W v _ _ No SEA Name of Hauler Destination Waste Product Licensed? MAN TOWN OF BARNSTABLE NCOMPIJANCE: • CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2.Printers n / � � -_ 3.Auto Body Shops COMPANY,_ 1/ {!�r(� '1 � O unsatisfactory' 4.Manufacturers (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS V. AA19AL3))fA6Z;� O)Class: 7.Miscellaneous �f YA nNN!S QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) j A Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply / / , . O Town Sewer OPublic . 0 71 �f g ' O On-site DPrivate i u 71, 3. Indoor Floor Drains YES NO O Holding tank: MDC / 0 Catch basin/Dry well O On-sites stem y 4. Outdoor Surface drains:YES NO -011DERS:t m 0 Holding tank:MDC tll ,I.. O Catch basin/Dry well O On-site system / 5.Waste Transporter L�CN�f Name of Hauler Destination Waste Product Licensed? ,f YES NO 2. i Person (s) Interviewed Inspector Date i Horsley Witten Group Sustainable Environmental Solutions 90 Route 6A=Unit 1 •Sandwich,MA 02563 508-833-66W•horsleywAten.com April 10, 2019 Mr.Thomas McKean Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Re: Phase IV Completion Statement and Permanent Solution Statement with No Condition Spartan Cleaners 242 Barnstable Road Hyannis, Massachusetts MassDEP RTN 4-24672 Dear Mr.Thomas McKean: This letter serves to notify you, as the representative of the Board of Health for the Town of Barnstable, of the completion and availability of a Permanent Solution Statement with No Conditions associated with Spartan Cleaners, located at 242 Barnstable Road, Hyannis, Massachusetts. The report is available for public review at the Commonwealth of Massachusetts Department of Environmental Protection ("MassDEP")Southeastern regional office, located in Lakeville, Massachusetts or at https://eeaonIine.eea.state.ma.us/portal#!/search/wastesite. This notification is being sent to you to comply with the Public Involvement requirements of the Massachusetts Contingency Plan,310 CMR 40.1403. If you have any questions, please contact Bryan Massa or Mark Nelson at 508-833-6600. Sincerely, HORSLEY WITTEN GROUP, INC. Bryan Massa, LSP Mark Nelson, P.G, LSP Senior Scientist Principal f PHASE IV COMPLETION STATEMENT AND PERMANANENT SOLUTION STATEMENT WITH NO CONDITIONS SPARTAN CLEANERS 242 BARNSTABLE ROAD HYANNIS, MASSACHUSETTS RELEASE TRACKING NUMBER 4-24672 Conclusion of Permanent Solution • The Exposure Point Concentration (EPC) for the soil is below the applicable Method S-1/GW-1 standard of 1 ug/Kg. At least 75%of the of the results included in the calculated EPCs are below the applicable Method 1 S-1/GW-1 standard. No sample included in the EPC is ten times the applicable standard. • PCE impacted groundwater flowed from the on-Site leaching facility, southeast toward Spring Street and Ridgewood Avenue. Concentrations of PCE in groundwater have ranged from below the laboratory reporting limit to a maximum of 20.5 ug/L. • A vapor intrusion assessment determined that vapor intrusion is not a concern at the Disposal Site. • Based on groundwater modeling completed by HW, groundwater at the Disposal Site was estimated to travel approximately 520 feet per year. Although this travel time is greater than 200 feet per year, a Critical Exposure Pathway or Imminent Hazard associated with a Condition of Substantial Release Migration was not identified. This model was used to document that there is no condition of substantial release migration associated with the site (HW, August 2014). • The Disposal Site is located within the mapped Zone II for the Maher Wellfield operated by the Hyannis Water District and is also located within a Town of Barnstable wellhead protection area. Based on groundwater modeling conducted by HW, groundwater from the Disposal Site does not flow to the Maher Wellfield. • Based on a drinking water well survey completed by HW and documented in the IRA Completion Report Dated August 4, 2014, all properties at least 2,000 feet downgradient of the Disposal Site are connected to the municipal drinking water supply. • The injection of 390 gallons of a modified Fenton's Reagent, consisting of 130 gallons of catalyst and 260 gallons of hydrogen peroxide, occurred on August 21, 2018 within and below the abandoned septic tank which appears to be the source of the release of PCE. The injection was successful in reducing PCE concentration in groundwater. As is typical with remedial injection, a slight increase in the concentration of PCE was observed in downgradient well MW-4 compared to ` previous sampling events. A decrease in PCE was observed over the subsequent monitoring events, consistent with the expectation of conducting remedial injections. • EPCs over the year for groundwater monitoring wells MW-4, MW-5, MW-12, MW- 15, and MW-21 (the "Disposal Site Groundwater Monitoring Network") are below the applicable GW-1 standard of 5 ug/L. At least 75%of the of the results included in the calculated EPC are below the applicable Method 1 S-1/GW-1 standard. No sample included in the EPC is ten times the applicable standard. • Pursuant to 310 CMR 40.1040(1), a Permanent Solutions shall apply where the following conditions exist. o (a)A level of No Significant Risk, as specified in 310 CMR 40.0900, exists or has been achieved. • As set forth in Section 8.5, a Method 1 Risk Characterization was conducted that concluded that a level of NSR exists at the Site. o (b)All sources of OHM impacts have been eliminated or controlled, as specified in 310 CMR 40.1003(5)(a)and(b). • As set forth in Section 6.0, the source of the OHM release appears to be associated with the historical discharge of residual levels of PCE between 1969 to 1999 to a septic system during the washing of laundered clothing in a washing machine. On- Site discharge of the wash water ceased in December 1999 when the Site was connected to the municipal sewer system. o (c) Control of plumes of dissolved OHM in groundwater and vapor-phase OHM in the vadose zone has been achieved as specified in 310 CMR 40.1003(6)(a). • Based upon the subsurface investigation conducted at the Disposal Site, groundwater and vapor phase OHM in the vadose zone is contracting. o (d)NAPL, if present, has been addressed as specified in 310 CMR 40.1003(6)(a). • As set forth in Section 8.3, NAPL has not been encountered at the Disposal Site and, based upon subsurface investigations, NAPL is unlikely to be present at the Site. o (e)All threats of release have been eliminated. • No threats of release, pursuant to 310 CMR 40.0006, have been identified within the Disposal Site boundary. o (f) The level of OHM concentrations in the environment have been reduced to as close to background levels as feasible, as specified at 310 CMR 40.1020. L1Massachusetts Department of Environmental Protection 1 eDEP Transaction Copy_ Here is the file you requested for your records. To retain a co of this file you must save and/or print. copy Y Username: HWITTENI Transaction ID: 1098234 Document: BWSC104 Permanent And Temporary Solution Statement Size of File: 220.98K Status of Transaction: Submitted Date and Time Created: 4/17/2019:9:27:42 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. f` assachusetts Department of Environmental Protection BWSC 104 12 r 4 ureau of Waste Site Cleanup Release Tracking Number ;lPERMANENT AND TEMPORARY SOLUTION STATEMENT _ ursuant to 310 CMR 40.1000(Subpart J) r24672 For sites with multiple RTNs,enter the Primary RTN above. A.SITE LOCATION: 1.Site Name/Location Aid: SPARTAN CLEANERS 2.Street Address: 242 BARNSTABLE ROAD 3.City/Town: HYANNIS 4.ZIP Code: 026010000 5.Coordinates: a.Latitude:N 41.65994 b.Longitude:W 70.28461 6.Check here if the disposal site that is the source of the release is Tier Classified.Check the current Tier Classification Category: r a.Tier I ri b.Tier ID c.Tier II B. THIS FORM IS BEING USED TO:(check all that apply) 1.List Submittal Date of the Permanent or Temporary Solution Statement, or RAO Statement(if previously submitted): mm/dd/yyyy 2.Submit a Permanent or Temporary Solution Statement r" a.Check here if this Permanent or Temporary Solution Statement covers additional Release Tracking Numbers (RTNs).RTNs that have been previously linked to a Tier Classified Primary RTN do not need to be listed here. b.Provide the additional Release TrackingNumber(s)covered by this Permanent or Temporary Solution Statement. n 3.Submit a Revised Permanent or Temporary Solution Statement(or revised RAO Statement) r` a.Check here if this Revised Permanent or Temporary Solution Statement covers additional Release Tracking Numbers(RTNs), not listed on the Permanent or Temporary Solution Statement or previously submitted Revised Permanent or Temporary Solution Statements.RTNs that have been previously linked to a Tier Classified Primary RTN do not need to be listed here. b.Provide the additional Release Tracking Number(s)covered by this - _ El -E Permanent or Temporary Solution Statement. ' rt 4.Submit a Permanent or Temporary Solution Partial Statement Check above box,if any Response Actions remain to be taken to address conditions associated with this disposal site having the Primary RTN listed in the header section of this transmittal form.This Permanent or Temporary Solution Statement will record only a Permanent or Temporary Solution-Partial Statement for that RTN.A final Permanent or Temporary Solution Statement will need to be submitted that references all Permanent or Temporary Solution-Partial Statements and,if applicable,covers any remaining conditions not covered by the Permanent or Temporary Solution-Partial Statements. Also,specify if you are an Eligible Person or Tenant pursuant to M.G.L.c.21 s.2,and have no further obligation to conduct response actions on the remaining portion(s)of the disposal site: a.Eligible Person b.Eligible Tenant 1 5.Submit a Revised Permanent or Temporary Solution Partial Statement(or revised RAO-Partial Statement) r°"j 6.Submit an optional Phase I Completion Statement supporting the Permanent or Temporary Solution Statement r; 7.Submit a Periodic Review Opinion evaluating the status of a Temporary Solution,as specified in 310 CMR 40.1051 (SectionF is optional) 8.Submit a Retraction of a previously submitted Permanent or Temporary Solution Statement(or RAO Statement) (Sections E&F are not required) (All sections of this transmittal form must be filled out unless otherwise noted above) Revised:6/21/2016 Page 1 of 8 / I assachusetts Department of Environmental Protection $WSC 104 12 ureau of Waste Site Cleanup Release Tracking Number ERMANENT AND TEMPORARY SOLUTION STATEMENT _ ursuant to 310 CMR 40.1000(Subpart J) 24672 L7 For sites with multiple RTNs,enter the Primary RTN above. C.DESCRIPTION OF RESPONSE ACTIONS: (check all that apply;for volumes,list cumulative amounts) 11.Assessment and/or Monitoring Only r_i 2.Temporary Covers or Caps r 3.Deployment of Absorbent or Containment Materials r',4.Treatment of Water Supplies 5.Structure Venting System/HVAC Modification System r,6.Engineered Barrier r 7.Product or NAPL Recovery r18.Fencing and Sign Posting r 9.Groundwater Treatment Systems F:lo.Soil Vapor Extraction V 11.Remedial Additives r-I 12.Air Sparging r 13.Active Exposure Pathway Mitigation System r_i 14.Passive Exposure Pathway Mitigation System Wi 15.Monitored Natural Attenuation 1 16.In-Situ Chemical Oxidation r,17.Removal of Contaminated Soils a.Re-use,Recycling or Treatment r i.On Site Estimated volume in cubic yards ii.Off Site Estimated volume in cubic yards iia.Facility Name: Town: State: iib.Facility Name: Town: State: iii.Describe: b.Landfill r-i.Cover Estimated volume in cubic yards Facility Name: Town: State: r ii.Disposal Estimated volume in cubic yards Facility Name: Town: State: r 18.Removal of Drums,Tanks or Containers: a.Describe Quantity and Amount: b.Facility Name: Town: State: c.Facility Name: Town: State: 19.Removal of Other Contaminated Media: a.Specify Type and Volume: b.Facility Name: Town: State: c.Facility Name: Town: State: Revised:6/21/2016 Page 2 of 8 assachusetts Department of Environmental Protection BWSC 104 12 ureau of Waste Site Cleanup r ERMANENT AND TEMPORARY SOLUTION STATEMENT Release Tracking Number ursuant to 310 CMR 40.1000(Subpart J) 24672 For sites with multiple RTNs,enter the Primary RTN above. C.DESCRIPTION OF RESPONSE ACTIONS(cont.):(check all that apply;for volumes,list cumulative amounts) r)20.Other Response Actions: Describe: r121.Use of Innovative Technologies: Describe: D. SITE USE: 1.Are the response actions that are the subject of this submittal associated with the redevelopment,reuse or the major expansion of the current use of property(ies)impacted by the presence of oil and/or hazardous materials? r a.Yes r7ei b.No r c.Don't know 2.Is the property a vacant or under-utilized commercial or industrial property("a brownfield property")? r a.Yes P7 b.No r.c.Don't know 3.Will funds from a state or federal brownfield incentive program be used on one or more of the property(ies)within the disposal site? r a Yes R b.No r c.Don't know If Yes,identify program(s): 4.Has a Covenant Not to Sue been obtained or sought? r a Yes r b.No r c.Don't know 5.Check all applicable categories that apply to the person making this submittal: a.Redevelopment Agency or Authority r b.Community Development Corporation r'c.Economic Development and Industrial Corporation r d.Private Developer r e.Fiduciary r f.Secured Lender r g.Municipality r It.Potential Buyer(non-owner) P i.Other,describe: PRO This data will be used by MassDEP for information purposes only,and does not represent or create any legal commitment,obligation or liability on the part of the party or person providing this data to MassDEP. E.PERMANENT OR TEMPORARY SOLUTION CATEGORY: Specify the category of Solution that applies to the Disposal Site,or Site of the Threat of Release.Select either 1,2,or 3. 1.Permanent Solution with No Conditions(check one) r a.A threat of release has been eliminated. rl b.All contamination has been reduced to Natural Background levels. c.A condition of No Significant Risk exists or has been achieved with no Activity and Use Limitation or other limitations, assumptions,or conditions(310 CMR 40.1013). Revised:6/21/2016 Page 3 of 8 f sachusetts Department of Environmental Protection BWSC 104 12 trs eau of Waste Site Cleanup ERMANENT AND TEMPORARY SOLUTION STATEMENT Release Tracking Number ursuant to 310 CMR 40.1000(Subpart 7) K 24672 For sites with multiple RTNs,enter the Primary RTN above. E.PERMANENT OR TEMPORARY SOLUTION CATEGORY(cont.): 2.Permanent Solution with Conditions(check a and/or b): r a.An AUL has been implemented pursuant to 310 CMR 1012(2)(check one) rii i.Required pursuant to 310 CMR 40.1012(2) Is the AUL required because the Permanent Solution relies on an Active Exposure Pathway Mitigation Measure q p Y g pursuant to CMR 310 40.1025? r 1.Yes r 2.No ii.Optionally implemented pursuant to 310 CMR 40.1012(3) b.Limitations or conditions apply pursuant to 310 CMR 40.1013(check all that apply): n i.Gardening Best Management Practices(BMPs)for non-commercial gardening in a residential setting ii.Concentrations of Oil and Hazardous Material consistent with Anthropogenic Background �® iii.Residual contamination in a Public or Railroad Right-of-Way iv.Groundwater contamination would exceed GW-2 Standards except for the absence of an occupied building or structure r 3.Temporary Solution(check a or b/and c) r l a.Response actions to achieve a Permanent Solution are not currently feasible j b.Response actions to achieve a Permanent Solution are feasible and are being continued toward a Permanent Solution r-1 c.Does the Temporary Solution rely on an Active Exposure Pathway Mitigation Measure pursuant to 310 CMR 40.1026? r i.Yes r ii.No F.PERMANENT AND TEMPORARY SOLUTION INFORMATION: 1.Specify the Risk Characterization Method(s)used to achieve the Permanent or Temporary Solution,described above: r a.Method 1 r l b.Method 2 r c.Method 3 r d.Method Not Applicable-Contamination reduced to or consistent with background,or Threat of Release abated 2.Specify all Soil Category(ies)applicable.More than one Soil Category may apply at a Site.Be sure to check off all APPLICABLE categories: ry a.S-1/GW-1 r d.S-2/GW-1 rg.S-3/GW-1 r j.Not Applicable r- b.S-I/GW-2 r e.S-2/GW-2 r h.S-3/GW-2 r, c.S-I/GW-3 r f.S-2/GW-3 r' i.S-3/GW-3 3.Specify all Groundwater Category(ies)impacted.A site may impact more than one Groundwater Category.Be sure to check off all IlVIPACTED categories: r a.GW-1 b.GW-2 rv- c.GW-3 r d.No Groundwater Impacted Revised:6/21/2016 Page 4 of 8 1 assachusetts Department of Environmental Protection BWSC 104 12 ureau of Waste Site Cleanup L7 , Release Tracking Number ERMANENT AND TEMPORARY SOLUTION STATEMENT _ ursuant to 310 CMR 40.1000(Subpart J) KI 24672 For sites with multiple RTNs,enter the Primary RTN above. F.PERMANENT AND TEMPORARY SOLUTION INFORMATION(cont.): r, 4.Check here if the risk assessment includes any changes to the groundwater category pursuant to 310 CMR 40.0932(5)(a)through(e).Check all conditions that apply: a.An InterimWellhead Protection Area does not apply based on a hydrogeologic evaluation(310 CMR 40.0932(5)(a)) r b.Groundwater was determined not to be in a Potentially Productive Aquifer or is not feasible to be developed as a drinking water supply(310 CMR 40.0932(5)(b)) c.A Non-Potential DrinkingWater Source Area determination was made(310 CMR 40.0932(5)(c)) r d.Existing private wells were permanently closed(310 CMR 40.0932(5)(d)) e.Groundwater is located within a Zone A,but is not hydrogeo logically connected to a drinking water supply (310 CMR 40.0932(5)(e)) 5.Check here if the Permanent or Temporary Solution supports a finding of No Significant Risk for petroleum in a GW-1 area pursuant to 310 CMR 40.0924(2)(b)3. 6.Specify whether remediation was conducted: a.Check here if soil remediation was conducted. r, b.Check here if groundwater remediation was conducted. c.Check here if other remediation was conducted. Specify: 7.Specify whether the analytical data used to support the Permanent or Temporary Solution used the Compendium of Analytical Methods(CAM): ry a.CAM used to support all analytical data. b.CAM used to support some of the analytical data. r c.CAM not used. 8.Check here to indicate that the Permanent or Temporary Solution Statement includes a Data Usability Assessment and Data Representativeness Evaluation pursuant to 310 CMR 40.1056. 9.Estimate the number of acres this Permanent or Temporary Solution Statement applies to: 4 Revised:6/21/2016 Page 5 of 8 assachusetts Department of Environmental Protection BWSC 104 12 L7 ureau of Waste Site Cleanup RMANENT AND TEMPORARY SOLUTION STATEMENT Release Tracking Number Ju, rsuant to 310 CMR 40.1000(Subpart J) [4::] 24672 For sites with multiple RTNs,enter the Primary RTN above. G.LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form,including any and all documents accompanying this submittal.In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and 309 CMR4.03(2),and(iii)the provisions of 309 CMR 4.03(3),to the best of my knowledge,information and relief, >if Section B indicates that either a Permanent or Temporary Solution Statement,Phase I Completion Statement and/or Periodic Review Opinion is being provided,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders,pe_-mits,and approvals identified in this submittal. I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 7893 2.First Name: MARK E 3.Last Name: NELSON 4.Telephone: 5088336600 5.Ext: 6.Email: 7.Signature: MARK E NELSON 8.Date: 4/10/2019 9.LSP Stamp: mm/dd/YYYY \Y11 led" ni _ Sed AVJ H.PERSON MAKING SUBMITTAL: 1.Check all that apply: a.change in contact name b.change of address r c.change in the person undertaking response actions 2.Name of Organization: SPARTAN CLEANERS INC 3.Contact First Name: DENNIS 4.Last Name: KARUKAS 5.Street: 242 BARNSTABLE RD 6.Title: 7.City/Town: HYANNIS 8.State: MA 9.ZIP Code: 026012930 10.Telephone: 5087758119 1L Ext.: 12.Email: DENNISKARUKAS@YAHOO.COM Revised:6/21/2016 Page 6 of 8 assachusetts Department of Environmental Protection BWSC 104 12 ureau of Waste Site Cleanup L7 ERMANENT AND TEMPORARY SOLUTION STATEMENT Release Tracking Number ursuant to 310 CMR 40.1000(Subpart J) 24672 For sites with multiple RTNs,enter the Primary RTN above. I.RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON MAKING SUBMITTAL: r Check here to change relationship v 1.RP or PRP r a.Owner r b.Operator 17 c.Generator r d.Transporter r�e.Other RP or PRP Specify: NONSPEGFIED PRP r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50)) r 4.Any Other Person Making Submittal Specify Relationship: J.REQUIRED ATTACHMENT AND SUBMITTALS: j 1.Check here if the Permanent or Temporary Solution on which this opinion is based,if any,are(were)subject to any order(s), permit(s)and/or approval(s)issued by DEP or EPA.If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. rl 2.Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the submittal of a Permanent or Temporary Solution Statement that relies on the public way/rail right-of-way exemption from the requirements of an AUL. 3.Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the submittal of a Permanent or Temporary Solution Statement with instructions on how to obtain a full copy of the report. ry 4.Check here to certify that documentation is attached specifying the location of the Site,or the location and boundaries of the Disposal Site subject to this Permanent or Temporary Solution Statement.If submitting a Permanent or Temporary Solution Statement for a PORTION of a Disposal Site,you must document the location and boundaries for both the portion subject to this submittal and, to the extent defined,the entire Disposal Site. rv; 5.Check here to certify that,pursuant to 310 CMR 40.1406,notice was provided to the owner(s)of each property within the disposal site boundaries,or notice was not required because the disposal site boundaries are limited to property owned by the party conducting response actions.(check all that apply) a.Notice was provided prior to,or concurrent with the submittal of a Phase II Completion Statement to the Department. b.Notice was provided prior to,or concurrent with the submittal of this Permanent or Temporary Solution Statement to the Department. r c.Notice not required. d.Total nurnber of property owners notified,if applicable: 18 6.Check here if you are submitting one or more AULs.You must submit an AUL Transmittal Form(BWSC113)and a copy of each implemented AUL related to this Permanent Solution or Temporary Solution Statement.Specify the type of AUL(s)below:(required for Permanent Solution with Conditions Statements where an AUL is being implemented) r a.Notice of Activity and Use Limitation b.Number of Notices submitted: r c.Grant of Environmental Restriction d.Number of Grants submitted: r 7.If a Permanent Solution Compliance Fee is required for any of the RTNs listed on this transmittal form,check here to certify that a Permanent Solution Compliance Fee was submitted to DEP,P.0.Box 4062,Boston,MA 02211. r; 8.Check here if any non-updatable information provided on this form is incorrect,e.g.Site Address/Location Aid.Send corrections to bwsc.edep@state.ma.us. li 9.Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised:6/21/2016 Page 7 of 8 I assachusetts Department of Environmental Protection BWSC 104 12 ureau of Waste Site Cleanup 7 Release Tracking Number ERMANENT AND TEMPORARY SOLUTION STATEMENT _ ursuant to 310 CMR 40.1000(Subpart J) 24672 For sites with multiple RTNs,enter the Primary RTN above. K.CERTIFICATION OF PERSON MAKING SUBMITTAL: 1.I, DENNIS KARUKAS attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii)that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal.I/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false, inaccurate,or incomplete information. 2.By: DENNIS KARUKAS 3.Title: Signature 4.For: SPARTAN CLEANERS INC 5.Date: 4/10/2019 (Name of person or entity recorded in Section H) mm/dd/yyyy rj 6.Check here if the address of the person providing certification is different from address recorded in Section H. 7.Street: 8.City/Town: 9.State: 10.ZIP Code: 11.Telephone: 12.Ext.: 13.Email: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Received by DEP on 4/10/20191:05:13 PM Revised:6/21/2016 Page 8 of 8 ILIMassachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: HWI T TEN1 Transaction ID: 1098229 Document: BWSC108 Comp. Res.Action Transmittal Form & Phase Size of File: 202.11 K Status of Transaction: Submitted Date and Time Created: 4/17f2019:9:26:34 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. it Massachusetts Department of Environmental Protection BWSC 108 Bureau of Waste Site Cleanup Release Tracking Number ' $ COMPREHENSIVE RESPONSE ACTION TRANSMITTAL ____ FORM&PHASE I COMPLETION STATEMENT 24672 Pursuant to 310 CMR 40.0484(Subpart D)and 40.0800(Subpart H) A.SITE LOCATION: 1.Site Name: SPARTAN CLEANERS 2. Street Address: 242 BARNSTABLE ROAD 3.City/Town: HYANNIS 4.ZIP Code: 026010000 r7o, 5.Check here if the disposal site that is the source of the release is Tier Classified.Check the current Tier Classification Category: o a.Tier I r-b.Tier ID ri c.Tier II B.THIS FORM IS BEING USED TO:(check all that apply) ri 1. Submit a Phase I Completion Statement,pursuant to 310 CMR 40.0484. 2. Submit a Revised Phase I Completion Statement,pursuant to 310 CMR 40.0484. 3. Submit a Phase II Scope of Work,pursuant to 310 CMR 40.0834. 4. Submit an interim Phase II Report.This report does not satisfy the response action deadline requirements in 310 CMR 40.0500. n 5. Submit a final Phase II Report and Completion Statement,pursuant to 310 CMR 40.0836. r- 6.Submit a Revised Phase II Report and Completion Statement,pursuant to 310 CMR 40.0836. r- 7.Submit a Phase III Remedial Action Plan and Completion Statement,pursuant to 310 CMR 40.0862. r 8. Submit a Revised Phase III Remedial Action Plan and Completion Statement,pursuant to 310 CMR 40.0862. 9. Submit a Phase IV Remedy Implementation Plan,pursuant to 310 CMR 40.0874. 10.Submit a Modified Phase IV Remedy Implementation Plan,pursuant to 310 CMR 40.0874. r 11.Submit an As-Built Construction Report,pursuant to 310 CMR 40.0875. r 12. Submit a Phase IV Status Report,pursuant to 310 CMR 40.0877. r 13. Submit a Phase IV Completion Statement,pursuant to 310 CMR 40.0878 and 40.0879. Specify the outcome of Phase IV activities:(check one) r a.Phase V Operation,Maintenance or Monitoring of the Comprehensive Remedial Action is necessary to achieve a Permanent or Temporary Solution. b.The requirements of a Permanent Solution have been met.A completed Permanent Solution Statement and Report . (BWSC104)will be submitted to DEP. r c.The requirements of a Temporary Solution have been met.A completed Temporary Solution Statement and Report (BWSC104)will be submitted to DEP. Revised:09/03/2013 Page 1 of 5 Massachusetts Department of Environmental Protection BWSC 108 Bureau of Waste Site Cleanup COMPREHENSIVE RESPONSE ACTION TRANSMITTAL Release Tracking Number L7' '-"1Xursuant 24672 ORM&PHASE I COMPLETION STATEMENT to 310 CMR 40.0484(Subpart D)and 40.0800(Subpart H) B.THIS FORM IS BEING USED TO(cont.): (check all that apply) r 14. Submit a Revised Phase IV Completion Statement,pursuant to 310 CMR 40.0878 and 40.0879. rl 15.Submit a Phase V Status Report,pursuant to 310 CMR 40.0892. r l 16. Submit a Remedial Monitoring Report.(This report can only be submitted through eDEP.) a.Type of Report:(check one) r i.Initial Report r ii.Interim Report r( iii.Final Report b.Frequency of Submittal:(check all that apply) rl i.A Remedial Monitoring Report(s)submitted monthly to address an Imminent Hazard. r ii.A Remedial Monitoring Report(s)submitted monthly to address a Condition of Substantial Release Migration. rl - iii.A Remedial Monitoring Report(s)submitted every six months,concurrent with a Status Report. rj iv.A Remedial Monitoring Report(s)submitted annually,concurrent with a Status Report. c. Status of Site:(check one) r i.Phase IV r ii.Phase V iii.Remedy Operation Status r iv.Temporary Solution d.Number of Remedial Systems and/or Monitoring Programs: A separate BWSC108A,CRA Remedial Monitoring Report,must be filled out for each Remedial System and/or Monitoring Program addressed by this transmittal form. r; 17. Submit a Remedy Operation Status,pursuant to 310 CMR 40.0893. M 18. Submit a Status Report to maintain a Remedy Operation Status,pursuant to 310 CMR 40.0893(2). r' 19.Submit a Transfer and/or a Modification of Persons Maintaining a Remedy Operation Status (ROS),pursuant to 310 CMR 40.0893(5)(check one,or both,if applicable). a.Submit a Transfer of Persons Maintaining an ROS(the transferee should be the person listed in Section D,"Person Undertaking Response Actions"). b. Submit a Modification of Persons Maintaining an ROS(the primary representative should be the person listed in Section D, "Person Undertaking Response Actions"). c.Number of Persons Maintaining an ROS not including the primary representative: ri 20.Submit a Termination of a Remedy Operation Status,pursuant to 310 CMR 40.0893(6).(check one) r a. Submit a notice indicating ROS performance standards have not been met.A plan and timetable pursuant to 310 CMR 40.0893(6)(b)for resuming the ROS are attached. r b. Submit a notice of Termination of ROS. r 21. Submit a Phase V Completion Statement,pursuant to 310 CMR 40.0894. Specify the outcome of Phase V activities:.(check one) r a.The requirements of a Permanent Solution have been met.A completed Permanent Solution Statement and Report(BWSC104)will be submitted to DEP. r b.The requirements for a Temporary Solution have been met.A completed Temporary Solution Statement and Report (BWSC104)will be submitted to DEP. r! 22. Submit a Revised Phase V Completion Statement,pursuant to 310 CMR 40.0894. r 23. Submit a Temporary Solution Status Report,pursuant to 310 CMR 40.0898. r 24.Submit a Plan for the Application of Remedial Additives near a sensitive receptor,pursuant to 310 CMR 40.0046(3). a.Status of Site: (check one) r i.Phase IV r ii.Phase V r iii.Remedy Operation Status r iv.Temporary Solution Revised:09/03/2013 Page 2 of 5 Massachusetts Department of Environmental Protection $WSC 108 Bureau of Waste Site Cleanup COMPREHENSIVE RESPONSE ACTION TRANSMITTAL Release Tracking Number 4 (24672 FORM&PHASE I COMPLETION STATEMENTL7' ] . I Pursuant to 310 CMR 40.0484(Subpart D)and 40.0800(Subpart H) C.LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form,including any and all documents accompanying this submittal.In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and 309 CMR 4.03(2),and(iii)the provisions of 309 CMR 4.03(3),to the best of my knowledge,information and belief, >if Section B indicates that a Phase I,Phase II,Phase III,Phase IV or Phase V Completion Statement and/or a Termination of a Remedy Operation Status is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are) appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L. c.2 1 E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal; > if Section B indicates that a Phase II Scope of Work or a Phase IV Remedy Implementation Plan is being submitted, the response action(s)that is(are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal; > if Section B indicates that an As-Built Construction Report, a Remedy Operation Status,a Phase IV,Phase V or Temporary Solution Status Report, a Status Report to Maintain a Remedy Operation Status, a Transfer or Modification of Persons - Maintaining a Remedy Operation Status and/or a Remedial Monitoring Report is being submitted, the response action(s)that is (are)the subject of this submittal(i)is(are)being implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,and(iii)comply(ies)with the identified provisions of all orders, permits,and approvals identified in this submittal. I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 7893 2.First Name: MARK E 3.Last Name: NELSON 4.Telephone: 5088336600 5.Ext.: 6.Email: 7.Signature: MARK ENELSON 8.Date: 4/10/2019 9.LSP Stamp: (mm/dd/yyyy) �\tlI t�f: , Revised:09/03/2013 Page 3 of 5 Massachusetts Department of Environmental Protection BWSC 108 Bureau of Waste Site Cleanup Release Tracking Number Ll COMPREHENSIVE RESPONSE ACTION TRANSMITTAL K1 - 24672 FORM&PHASE I COMPLETION STATEMENT I ' J Pursuant to 310 CMR 40.0484(Subpart D)and 40.0800(Subpart H) D.PERSON UNDERTAKING RESPONSE ACTIONS: 1.Check all that apply a.change in contact name r b. change of address r:c.change in the person undertaking response actions 2.Name of Organization: SPARTAN CLEANERS INC 3.Contact First Name: DENNIS 4.Last Name: KARUKAS 5.Street: 242 BARNSTABLE RD 6.Title: 7.City/Town: HYANNIS 8.State: MA 9.ZIP Code: 026012930 10.Telephone: 5087758119 11.Ext: 12.Email: DENNISKARUKAS@YAHOO.COM E.RELATIONSHIP TO SITE OF PERSON UNDERTAKING RESPONSE ACTIONS: r-Check here to change relationship 1.RP or PRP rl a. Owner r b.Operator r c.Generator r d.Transporter r e.Other RP or PRP Spec:fy: NON-SPECIFIED PRP r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50)) r 4.Any Other Person Undertaking Response Actions Specify Relationship: F.REQUIRED ATTACEMENT AND SUBMITTALS: r 1.Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s) and/or approval(s)issued by DEP or EPA.If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. 1✓ 2.Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the submittal of any Phase Reports to DEP. r 3.Check here to certify.that the Chief Municipal Officer and the Local Board of Health have been notified of the availability of a Phase III Remedial Action Plan. j 4.Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the availability of a Phase IV Remedy Implementation Plan. r 5.Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of any field work involving the implementation of a Phase IV Remedial Action. rl 6.If submitting a Transfer of a Remedy Operation Status(as per 310 CMR 40.0893(5)),check here to certify that a statement detailing the compliance history for the person making this submittal(transferee)is attached. rI 7.If submitting a Modification of a Remedy Operation Status(as per 310 CMR 40.0893(5)),check here to certify that a statement detailing the compliance history for each new person making this submittal is attached. 1. l 8.Check here if any non-updatable information provided on this form is incorrect,e.g.Release Address/Location Aid.Send corrections to:BWSC.eDEP@state.ma.us. rv, 9.Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised:09/03/2013 Page 4 of 5 Massachusetts Department of Environmental Protection BWSC 108 Bureau of Waste Site Cleanup L71COMPREHENSIVE RESPONSE ACTION TRANSMITTAL Release Tracking Number FORM&PHASE I COMPLETION STATEMENT 4 24672 Pursuant to 310 CMR 40.0484(Subpart D)and 40.0800(Subpart H) G.CERTIFICATION OF PERSON UNDERTAKING RESPONSE ACTIONS: 1. I DENNIS KARUKAS ,attest under the pains and penalties of perjury i that I have personally P P P J rY() P Y examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal.I/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. >if Section B indicates that this is a Modification of a Remedy Operation Status(ROS),I attest under the pains and penalties of perjury that I am fully authorized to act on behalf of all persons performing response actions under the ROS as stated in 310 CMR 40.0893(5)(d)to receive oral and written correspondence from MassDEP with respect to performance of response actions under the ROS,and to receive a statement of fee amount as per 4.03(3). I understand that any material received by the Primary Representative from MassDEP shall be deemed received by all the persons performing response actions under the ROS,and I am aware that there are significant penalties,including,but not limited to, possible fines and imprisonment,for willfully submitting false,inaccurate or incomplete information. 2.By: DENNIS KARUKAS 3.Title: Signature 4.For: SPARTAN CLEANERS INC 5.Date: 4/10/2019 (Name of person or entity recorded in Section D) (mm/dd/yyyy) r 6.Check here if the address of the person providing certification is different from address recorded in Section D. 7. Street: 8.City/Town: 9. State: 10.ZIP Code: 11.Telephone: 12.Ext.: 13.Email: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Received by DEP on 4/10/2019 1:05:42 PM Revised:09/03/2013 Page 5 of 5 IKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 Y RARMARSRLE.�` 200 Main Street• Hyannis, MA 02601 �ArEOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 1 h� /'5 Date: Location/Mailing Address: PL4 :9 Y9 & Contact Name/Phone: Q P n» `g Q ru )sf*s �� Inventory Total Amount: MSDS: License#: 1051 Tier II YV 1 15, Labeling: YF-5 — Spill Plan: YES Oil/Water Separat r: w�C Floor Drains: �/' Emergency Numbers: Yc—S Storage Areas/Tanks: O ipo A Emergency/Containment Equwoment: S — �r►�tN )3vc- (°a'I-r 1, Pc (4 1 Waste Generator ID: MA IO �19 J1)'I I`f 7 Waste Product: r� Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: SLe Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid _Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils ¢/ Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible f� — %7— 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: IVO W t✓ ' A ORDERS: INFORMATION/RECOMMENDATIONS: )Vd-V IL Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FtNE rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABNABLE.9` 200 Main Street• Hyannis, MA 02601 t639 61 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 P'� M �.., Business Name: SPGt 4an dean" Date: 6/011D ta o Iq Location/Mailing Address: a 91113 4 nQuble Contact Name/Phone: ' GGS Inventory Total Amount: SDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: U Floor Drains: Emergency Numbers: Storage Areas/Tanks: OZ Emergency/Containment Equipment: Waste Generator ID: MAPIi h19 Waste Product: Date&Amount of Last Shi ment/Fre uenc Licensed Waste Hauler&Destinatio Other Waste Disposal Methods: i LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license fro the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible J 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/RE OMMEN ATIONS: `Y�i ? , eori,t/ re � Inspector: _ Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS t Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA 9BLE. 200 Main Street• Hyannis, MA 02601 plfDMA'�e�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: � ar te4-w C(eA.Kt f5 Date: Location/Mailing Ad ress: 2 Z IQar S ab Hh 1 S Contact Name/Phone: )e- YYII S'v$--7 S— 911 �1 , SOS-38�` 39$ Inventory Total Amount: N �.S9 G, SDS: {,S License#: Z. Tier II : NO Labelina: Spill Plan: 2g Oil/WaterSeparator: Floor D ains: o Emergency Numbers: -0-S Storage Areas/Tanks: w Ste. 69y0Vc4)w--f'. OLO6-e. oA, ,r, Emer enc /ContainmentE ui ment: ,<e. e,, %v- u4¢S -c�b ., Cv►1���v� 11� of e, Waste Generator ID: 01°I I11 Waste Product: 1aC� Date&Amount of Last Shi ment/Fre ue c : t 11 t o v b Licensed Waste Hauler&Destination: -s a or�,e, Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS JJ p � r�f� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws o A, hazardous materi I use, t%0 storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash nn Motor oils Miscellaneous Corrosives be" l•a.{ Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: 5 S O<, Q. ,Ke Inspector: LQV ' e— Facility Representative: 1 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS i I►IE►ok1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARN P�E. ' 200 Main Street• Hyannis, MA 02601 �ArFOMP�a`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: :5 �r C ea�c-t'S Date: Location/Mailing Address: 2 2 Contact Name/Phone: Inventory Total Amount: �' Q ��'I &S: License#: I Tier II o? 4 L eling: Spill Plan: )k5 Oil/WaterSeparator: n Floor Drains: Emergency Numbers: le,S Storage Areas/Tanks: — �^��^nn b l E w c.S 2 ce �� 2 Emergency/Containment E ui ent: to �.�•�0.,k} � ��•� �s� 5 Waste Generator ID: \ l'- Waste Product: L 2g vc, Date&Amount of Last Shipment/Frequencx: 3 11 1p -I- 00 Licensed Waste Hauler&Destination: N ew h g*Zyv ,1"A-e. Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids goo IYL tM"3 ISe Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers NZo �41 Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" S � ) (including chloroform, formaldehyde, ©�I e�'Cs��w� hydrochloric acid, other acids) VIOLATIONS: of �t 1Uo4 ORDERS. w W�5 �J bGuw�-4 c� �o w ovt— L <o INFORMATION/RE OMMENDATIONS: ALW V v C a,01 q U S Inspector: 1 Lqv-e Facility Representative: WHITE COPY-HEALTH/DEPARTMENT/CANARY COPY- BUSINESS r T KTEX 2014 USA BA DAHL Safety Data Sheet according to Federal Register I Vol.77,No.58/Monday,March 26,2012/Rules and Regulations a Date of issue:02/01/2016 Version:1.0 A. identification Product form Mixture Name KTEX 2014 USA Product code 41797(200L),41798(20L) 1.2. Relevant identified uses_of the substance or mixture and uses advised against Use of the substance/mixture. Dry-cleaning solvent 1.3. Detailsof the supplier of the safety data sheet BARDAHL MANUFACTURING CORPORATION 1400 N.W.52ND Street PO BOX 70607 SEATTLE,WA 98127-0607 T Office:206-783-4851 /Toll Free: 1-888-227-3245(888-BARDAHL)-F 206-784-3219 customerservice(obardah l.com 1.4. Emergency_telephone number Country Organisation/Company Address Emergency number USA American Association of Poison Control Centers 515 King Street,Suite 510 1-800-222-1222 VA 22314 Alexandria 2A. Classification of the substance or mixture GHS-US classification Flam.Liq.4 H227 Skin Sens.1 H317 Asp.Tox. 1 H304 Full text of H-statements:see section 16 2.2. Label elements GHS-US labelling Hazard pictograms(GHS-US) 1 • GHS07 GHS08 Signal word(GHS-US) Danger Hazard statements(GHS-US) H227-Combustible liquid H304-May be fatal if swallowed and enters airways H317-May cause an allergic skin reaction Precautionary statements(GHS-US) P210-Keep away from heat,hot surfaces,sparks,open flames and other ignition sources.No smoking P261 -Avoid breathing vapours P272-Contaminated work clothing must not be allowed out of the workplace P280-Wear protective gloves,eye protection P301+P310-If swallowed:Immediately call a POISON CENTER,a doctor P302+P352-If on skin:Wash with plenty of soap and water P321 -Specific treatment(see supplemental first aid instruction on this label) P331 -Do NOT induce vomiting P333+P313-If skin irritation or rash occurs:Get medical advice/attention P363-Wash contaminated clothing before reuse P370+P378-In case of fire:Use carbon dioxide(CO2),foam,hazy water,powder to extinguish P403+P235-Store in a well-ventilated place.Keep cool P405-Store locked up P501 -Dispose of contents/container to an approved waste disposal plant 02/01/2016 EN(English) Page 1 � T BA y AHL E MdrtR9 KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations 2.3. Other hazards Other hazards not contributing to the Heavier than air,vapours may travel long distances along ground,ignite and flash back to classification. source. 2.4. Unknown acute toxicity_(GHS US) Not applicable o •• - 3.1. Substance Not applicable 3.2. Mixture Name Product identifier %. -_--- GHS-US classification Hydrocarbons,C10-C13,n-alkanes,isoalkanes,cyclics,<2% (CAS No)6474248-9 90-100 Flam.Liq.4,H227 aromatics Asp.Tox.1,H304 3-butoxypropan-2-ol,propylene glycol monobutyl ether (CAS No)5131-66-8 1-4 Flam.Liq.4,H227 Skin Irrit.2,H315 Eye Irrit.2A,H319 Terpenes and Terpenoids,sweet orange-oil (CAS No)68647-72-3 <3 Flam.Liq.3,H226 Skin Irrit.2,H315 Skin Sens.1,H317 Asp.Tox.1,H304 Aquatic Acute 1,H400 Aquatic Chronic 1,H410 Full text of H-statements:see section 16 4.1. Description of first aid measures First-aid measures after inhalation Move the affected person away from the contaminated area and into the fresh air.Allow the victim to rest.Get medical advice/attention if you feel unwell. First-aid measures after skin contact Remove all contaminated clothing and footwear.Wash skin thoroughly with mild soap and water.If case of redness or irritation,call a doctor. First-aid measures after eye contact Rinse immediately and thoroughly,pulling the eyelids well away from the eye(15 minutes minimum).If irritation persists,consult an eye specialist. First-aid measures after ingestion Do NOT induce vomiting.If swallowed,seek medical advice immediately and show this container or label. 4.2. Most important symptoms and effects,both acute and delayed Symptoms/injuries after inhalation + May cause irritation to the respiratory tract.This material or its emissions may affect the nervous system. Symptoms/injuries after skin contact May cause an allergic skin reaction.Repeated exposure may cause skin dryness or cracking. Symptoms/injuries after eye contact Direct contact with the eyes is likely to be irritating. Symptoms/injuries after ingestion Abdominal pain,nausea.Diarrhea.Risk of lung oedema.Death. 4.3. Indication of any immediate medical attention and special Ireatment needed Treat symptomatically. o • • 5.1. Extinguishing media Suitable extinguishing media Carbon dioxide(CO2).Water spray.Foam.Dry powder. Unsuitable extinguishing media Do not use a heavy water stream. 5 2. Special hazards-arising from the substance or mixture Fire hazard Combustible liquid.Heavier than air,vapours may travel long distances along ground,ignite and flash back to source.Incomplete combustion releases dangerous carbon monoxide, carbon dioxide and other toxic gases.Hydrocarbons. Reactivity To our knowledge,the product does not present any particular risk,under normal conditions of use. 62/01/2016 EN(English) 2/8 i BA y AHL KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations 5.3. Advice for firefighters Firefighting instructions Use water spray or fog for cooling exposed containers.Contain the extinguishing fluids by bunding. Protection during firefighting Do not attempt to take action without suitable protective equipment.Self-contained breathing apparatus.Complete protective clothing. o • 6.1. Personal pre cautions,,protective equipment and emergency procedures General measures Remove all sources of ignition. 6.1.1. For Y non-emer enc personnel 9 Protective equipment Avoid contact with skin and eyes.Do not breathe vapours. 6.1.2. For emergency responders Protective equipment Only qualified personnel equipped with suitable protective equipment may intervene.Equip cleanup crew with proper protection.For further information refer to section 8:"Exposure controls/personal protection". 6.2. Environmental precautions Avoid release to the environment.Prevent entry to sewers and public waters.Notify authorities if liquid enters sewers or public waters. 6.3. Methods and material for containment and cleaning.up For containment Take up liquid spill into absorbent material,e.g.:sand,earth,vermiculite,kieselguhr,powdered limestone.Shovel into suitable and closed container for disposal Methods for cleaning up Wash contaminated area with large amounts of water.Dispose of contaminated materials in accordance with current regulations. 6.4. Reference to other sections No additional information available 0 • • • -mama J7.1_. Precautions for safe handling Additional hazards when processed Ensure good ventilation of the work station. Precautions for safe handling Avoid contact with skin and eyes.Do not breathe vapours.Use non-sparking tools.Remove all sources of ignition. Hygiene measures Do not drink,eat or smoke in the workplace.Wash hands and other exposed areas with mild soap and water before eating,drinking or smoking and when leaving work.If on skin,take off contaminated clothing. 7.2. Conditions for_safe storage,including any_incompatibilities Storage conditions Keep container tightly closed.Store in dry,cool,well-ventilated area.Keep away from sources of ignition.Keep away from heat. Incompatible products Strong acids.Oxidation agents. Maximum storage period 3 years Special rules on packaging Keep only in original container. 8.1. Control parameters No additional information available 8.2. Exposure controls Appropriate engineering controls Ensure good ventilation of the work station. Hand protection Protective gloves.Breakthrough time:refer to the recommendations ofthe supplier. Eye protection Chemical goggles or safety glasses. Skin and body protection Wear suitable protective clothing. Respiratory protection In case of insufficient ventilation,wear suitable respiratory equipment. 02/0 1 12 0 1 6 EN(English) 3/8 BA y AHL KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58 I Monday,March 26,2012/Rules and Regulations 9.1. Information on basic physical and chemical properties Physical state Liquid Colour Colourless Odour characteristic Odour threshold No data available pH Not applicable Melting point No data available Freezing point No data available Boiling point 185-220°C Flash point >61 'C Relative evaporation rate(butyl acetate=1) No data available Flammability(solid,gas) No data available Explosive limits 0.6-6.1 vol% Explosive properties No data available Oxidising properties No data available Vapour pressure No data available Relative density 0.8-0.815 Relative vapour density at 20°C No data available Solubility No data available Log Pow No data available Auto-ignition temperature >230°C Decomposition temperature 235-315°C Viscosity 1.5 mm2/s(40'C) Viscosity,kinematic No data available Viscosity,dynamic No data available 9.2. Other information No additional information available 10.1.- Reactivity To our knowledge,the product does not present any particular risk,under normal conditions of use. 10.2. Chemical stability Stable under use and storage conditions as recommended in section 7. 10.3. Possibility of hazardous reactions Combustible liquid.Heavier than air,vapours may travel long distances along ground,ignite and flash back to source. 10.4. Conditions to avoid Heat.No flames,no sparks.Eliminate all sources of ignition.Avoid the build-up of electrostatic charge Incompatible materials Strong acids.Strong oxidizers. 10.6. Hazardous decomposition products Under normal conditions of storage and use,hazardous decomposition products should not be produced. 02/01/2016 EN(English) 4/8 i "A '-AHL KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations 11.1._ - Information on toxicological effects Acute toxicity Not classified (Based on available data,the classification criteria are not met) Hydrocarbons,60-613,n-alkanes,isoalkanes,cyclics,<2%aromatics(64742-48-9) LD50 oral rat >5000 mg/kg(OECD 401) LD50 dermal rabbit >5000 mg/kg(OECD 402) LC50 inhalation rat >4951 mg/m'(4h-OECD.403) Skin corrosion/irritation Not classified (Based on available data,the classification criteria are not met) pH:Not applicable Serious eye damage/imitation Not classified (Based on available data,the classification criteria are not met) pH:Not applicable Respiratory or skin sensitisation May cause an allergic skin reaction. Germ cell mutagenicity Not classified (Based on available data,the classification criteria are not met) Carcinogenicity Not classified (Based on available data,the classification criteria are not met) Reproductive toxicity Not classified (Based on available data,the classification criteria are not met) Specific target organ toxicity(single exposure) Not classified (Based on available data,the classification criteria are not met) Specific target organ toxicity(repeated Not classified exposure) (Based on available data,the classification criteria are not met) Aspiration hazard May be fatal if swallowed and enters airways. Symptoms/injuries after inhalation May cause irritation to the respiratory tract.This material or its emissions may affect the nervous system. Symptoms/injuries after skin contact May cause an allergic skin reaction.Repeated exposure may cause skin dryness or cracking. Symptoms/injuries after eye contact Direct contact with the eyes is likely to be irritating. Symptoms/injuries after ingestion Abdominal pain,nausea.Diarrhea.Death. 1201. Toxicity Ecology-general Harmful to aquatic life with long lasting effects. Hydrocarbons,C10-C13,n-alkanes,isoalkanes,cyclics,<2%aromatics(64742-48-9) LC50 fish >1000 mg/I(Onchorhyncus mykiss-96h) EC50 Daphnia >1000 mg/I(Daphnia magna,48h) EC50 other aquatic organisms >1000 mg/I EC50 waterflea(48 h) EC50 other aquatic organisms >1000 mg/I IC50 algea(72 h)mg/I 12.2. Persistence and degradability_ Hydrocarbons,C10 C13,n-alkanes,isoalkanes,cyclics,<2%aromatics(64742-48-9) Persistence and degradability Readily biodegradable. 02101/2016 EN(English) 5/8 BA ­AHL KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations 12.3. Bioaccumulative potential No additional information available 12.4. _Mobility in soil No additional information available 12.5. Other adverse effects Effect on the ozone layer No known effects from this product. Effect on global warming No known effects from this product. &*1000111MR21191MISM 6roll • • 13.1. Waste treatment methods Waste disposal recommendations Do not discharge into the sewer.Dispose of in accordance with relevant local regulations. Additional information Empty the packaging completely prior to disposal.Recycle or dispose of in compliance with current legislation. Department of Transportation(DOT) In accordance with DOT Not regulated for transport TDG No additional information available Transport by sea No additional information available Air transport No additional information available 15.1.US Federal regulations KTEX 2014 USA SARA Section 311/312 Hazard Classes Fire hazard Immediate(acute)health hazard Hydrocarbons,C10-C13,n-alkanes,isoalkanes,cyclics,<2%aromatics(6474248-9) Listed on the United States TSCA(Toxic Substances Control Act)inventory Not subject to reporting requirements of the United States SARA Section 313 — -- -h- ---- _ 3-6utoxypropan-2-ol,propylene glycol monobutyl ether(5131-66-8) Listed on the United States TSCA(Toxic Substances Control Act)inventory Not subject to reporting requirements of the United States SARA Section 313 Terpenes and Terpenoids,sweet orange-oil(68647-72-3) Listed on the United States TSCA(Toxic Substances Control Act)inventory Not subject to reporting requirements of the United States SARA Section 313 02/01/2016 EN(English) 6/8 BA y AHL KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations 15.2.International regulations CANADA Hydrocarbons,C10-C13,n-alkanes,isoalkanes,cyclics,<2%aromatics(64742-48-9) Listed on the Canadian DSL(Domestic Substances List) 3-butoxypropan-2-ol,propylene glycol monobutyl ether(5131-66-8) Listed on the Canadian DSL(Domestic Substances List) Terpenes and Terpenoids,sweet orange-oil(68647-72-3) Listed on the Canadian DSL(Domestic Substances List) National regulations Terpenes and Terpenoids,sweet orange-oil(68647-72-3) Listed on the AICS(Australian Inventory of Chemical Substances) Listed on IECSC(Inventory of Existing Chemical Substances Produced or Imported in China) Listed on the Korean ECL(Existing Chemicals List) Listed on NZIoC(New Zealand Inventory of Chemicals) Listed on PICCS(Philippines Inventory of Chemicals and Chemical Substances) 15.3.US State regulations KTEX 2014 USA U.S.-California-Proposition 65-Other This product does not contain any substances known to the state of California to cause information cancer and/or reproductive toxicity ol L,10-9 Call Data sources SDS of suppliers. Full text of H-statements: Aquatic Acute 1 Hazardous to the aquatic environment—Acute Hazard,Category 1 Aquatic Chronic 1 Hazardous to the aquatic environment—Chronic Hazard,Category 1 Aquatic Chronic 3 Hazardous to the aquatic environment—Chronic Hazard,Category 3 Asp.Tox. 1 Aspiration hazard,Category 1 Eye Irrit.2A Serious eye damage/eye irritation,Category 2A Flam.Liq.3 Flammable liquids,Category 3 Flam.Liq.4 Flammable liquids,Category 4 Skin Irrit.2 Skin corrosion/irritation,Category 2 Skin Sens. 1 Sensitisation—Skin,Category 1 H226 Flammable liquid and vapour H227 Combustible liquid H304 May be fatal if swallowed and enters airways H315 Causes skin irritation H317 May cause an allergic skin reaction H319 Causes serious eye irritation H400 Very toxic to aquatic life H410 Very toxic to aquatic life with long lasting effects H412 Harmful to aquatic life with long lasting effects 02/01/2016 EN(English) 7/8 BA _ AHL E KTEX 2014 USA Safety Data Sheet according to Federal Register/Vol.77,No.58/Monday,March 26,2012/Rules and Regulations HMIS III Rating Health 3 Serious Hazard - Major injury likely unless prompt action is taken and medical treatment is given Flammability 2 Moderate Hazard-Materials which must be moderately heated or exposed to high ambient temperatures before ignition will occur.Includes liquids having a flash point at or above 100 F but below 200 F.(Classes II&IIIA) Physical 0 Minimal Hazard-Materials that are normally stable,even under fire conditions,and will NOT react with water,polymerize,decompose,condense,or self-react.Non-Explosives. Personal Protection B-Safety glasses,Gloves SIDS US(GHS HazCom 2012) This information is based on our current knowledge and is intended to describe the product for the purposes of health,safety and environmental requirements only.It should not therefore be construed as guaranteeing any specific property of the product 02/01/2016 EN(English) 8/8 Fn�rok, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • eA A MASS.SS. • 200 Main Street• Hyannis, MA 02601 039. �'OrFDMP�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: s1P4V- ,Vt_ C,(c.a,vA-rs Date: Location/Mailing Address: 2 q 2- 8g<-A s+, 0 l,-- R.Q Contact Name/Phone: V\A%gtio9- ?T - Sl t 3$<= 7 3`jo Inventory Total Amount: '� �) MSDS: C" License#: Tier II : -N* Labeling: Spill Plan: 2S Oil/Water Separator: Floor Drains: N o Emergency Numbers: � Storage Areas/Tanks: 1L-1S &k 1<0m.S war, G- 2�old Emergency/Containment Equipment: t ti ,ti . A 4lte V �`"� r�►^tiS Waste Generator ID: Mfl 19 1 2 I tA-1 Waste Product: 6- Date&Amount of Last Shipment/Frequency: VS I( Z. a t �. 2X r Licensed Waste Hauler&Destination:5_ 41:�,j Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze 90 Dry cleaning fluids ,2$1D ?"Ll `A Automatic transmission fluid to Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Mb t S,Cs 01 '(4- 4-A- swS A-LW vJ av�c� S +c� kst�J �o�xe�.Inspector:� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TTowti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9B "MASS. 200 Main Street• Hyannis, MA 02601 1639*�ArFOMA�a`0 cTOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT cJ Business Name: at 4et t L ( eq ve-rS Date: �d Location/Mailing Ad ress: Z 'Z- �Q�r1 a. fie_ RK,7 Contact Name/Phone: eu✓1� s a���2a S 51�-77 - Sit Inventory Total Amount: ti ao r,al MSDS: Y6 License#: 91 Tier II NA Labeling: A10.6L Spill Plan: Ye-5 Oil/WaterSeparator: fl) Floor Drains: 5NO Emergency Numbers:_ Q Storage Areas/Tanks: :25'0 Ga,l 154*ora4&1 1e4- Emergency/Containment Equipment: Waste Generator ID: 1A�> 01 1 t'L t Waste Product: (+4-rS Date&Amount of Last Shipment/Frequency: 5 N q 1 1 + t. 28 It 6 Do + 140 t b S n. ^0 •5 Licensed Waste Hauler&Destination: 6AS-0-1-y i<leze 14e, Dv, to H' Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze ,2�1� Dry cleaning fluids ',(,SO Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: V2,5veA, a-1 <e- af h WIJ-- w%n. o ovw fo.M w��el aye• e�, we,1 •�sl� k•t�er� — a m�l� ti)+���� �00-N, Vk VA, by ev.g Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°Ftue►cam Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • sneMA.S% • 200 Main Street• Hyannis, MA 02601 eo59. +1, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: J a r-Fa vL e Vto f-s Date: Location/Mailing A dress: Arts Able RX V 4 K,1 I S Contact Name/Phone: b&-Av%,s KA-ro lea-S .Sog - -75-8/19 , 5-00-3,35-93` 0 Inventory Total Amount: ti��o 410 MSDS: A6 License#: I a S Tier II : M 1A Labeling: 4r,9,,,oV Spill Plan: _ Oil/WaterSeparator: 4,t Floor Drains: _)o Emergency Numbers: yeS Storage Areas/Tanks: a,l 1011 t c.l15 o✓tl - 25-0 al 1K. nnaLtA4I.0 Emer enc /Containment ui ment: IV &JA'-,. ig—L&wAwy eaw+et%%&w oVk Waste Generator ID: /►�I D Iq q is 141 Waste Product: Date&Amount of Last Shipment/Frequency: ?h0h4 I ohs I, v4J o0/b5 1 r,5 Licensed Waste Hauler&Destination: $a�'e k eGn caasks•. Other Waste Disposal Methods: ..0cStz- s It b w. . ,�` •, s s b - ���5 G>^,e.. � wt..�J ER L ordt-�cd2,t wA.S t."--�,�,�.w.Ne. ,,,� edv IL a •�5 LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze VCI..D 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 be,�er�las► c, Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: o c55Vf-h 9< Lco , ,wA.. Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 1 / 7 / 1 `/ TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGMTFWTM FORM NAME OF BUSINESS: ,4-gvt CleaVVE(Is BUSINESS LOCATION: .2q2 6-4414a,bl.e— U, -c✓I/11.5 INVENTORY MAILING ADDRESS: �5, ,tyi - TOTAL AMOUNT- TELEPHONE NUMBER: ,�48 -175— 811 f ^- 290 4l/BM,5 CONTACT PERSON: Kc v k-4-5 EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: < Q44",1- C Ye INFORMATION / RECOMM NDATIONS: o,v) e�c lD�aK. �Kcly Fire District: P�V�I?�l �C �lownnt f6 s ,// ocvits E{ 4�rt G a Q�5 afL dGi tG 40 d bo,IA ni-r Ga01 I Ill . ,� �. Waste Twa mk>otIgM1L17 Last shipment of hazardous waste: l0 8 Name of Hauler: Sa�'�k �Clee.�. Destination:C A,144rboV-s, Le6m. ©�! Waste Product: Licensed "�.`% No eK,DF,9a58736 y NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes 4j6 t, ^- ;3D j LjjVV%.4 Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids 0 (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials 9r7 Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------- ----------------------------------------I------- --------------------------------------------- - -------------------------------------------------------------- ----------------------------- -------- - - This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health I Town of Barnstable Inspectional Services E*1' �Z�� �;Public Health Division 5;E, .°�� BARNSMBLE, ` Thomas McKean, Director r. 9 i639. `0$ IND 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790'j.304 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 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499'Gallons: - $125.00 Izv's . CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ �fch *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. �Ly-( L, - 3 2% b`0 2. IS THIS A PERMIT RENEWAL? YES 'V NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF . GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �'(]_'(\� Cal)►\ 5. NAME OF ESTABLISHMENT: G�Yl �aYS 6. ADDRESS OF ESTABLISHMENT: 2- I 6�9 6 Q. R4 65 D 1' 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 5 AYhf 8. TELEPHONE NUMBER OF ESTABLISHMENT: M, 9. EMAIL ADDRESS: QAY&040Y7 9?�tDA 601-.44ADb .C$y►n 10. SOLEOWNER: V/^YES NO IF NO,NAME OF PARTNER: 11. NAME,HOMEADDRESS,ry TELEPHONE FULL AND TELEPNc#O r CORPORATION A S y ,-P,� i 1 PRESIDENT TREASURER S CLERK C' 1) CL Ka6'L� 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: E SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials, -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. --------------------- - ----------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health loewgulatoryof B4rns able � V(aCh� StpS�Jem es 411, Richard V. Scah, Director " MA TKE Public Health Division BAMSTABLE ` • . }• �sTT,E�•ca�•mnrr•Warns B"NffrABLE. 0 Thomas McKean,Director WSTOM15Ni3.OSTEAVW-VFS STU& a NtAF& 1639-2014 059. 5�A � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 �O" Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS U1 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 �0 V S . CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO._21� - 0 1b 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YO:S, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. r 4. FULL NAME OF APPLICANT: �� Q,y��'�5 C T 1 !Q ni ca-< 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: �x�)11h Sf1e� Q y�ra-h�a .aC't'Sln'1 10. SOLEOWNER: /"YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAMES Cw.h ei^_5 PRESIDENT 3 ;L,- TREASURER CLERK_ 0.40 k�A rg jNk-&S 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE f l Q\Application FormsUTAZMAT APP 2017 REVISEDA `/ I� Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Z:I0Nd LT Z C r NjIf 7h0c Furs �uede•Leather CO,cl Storage CLEANERS Wedding Gow+ PreservaVpn Tag`Vag Sehvice Monday-Friday 7:30am-5:00pm Saturday 7:30am-3:00pm 04t�hg CQeaVtiVtg \Is CPnornpt,CPno�essiou�gQ Senvice 5 8'775-9119 i 4 f� Tow1� of B ry sable ' Regi%atory ices �t�, Richard V. Scali, Director o Public Health Division BARN ST"ABLE BARN Director 1639 � �RP,51[F:HWS (51:lIVIl1E� i`PO N5f4� LE. Thomas McKeanMASS. , -2014� 94ipreo 59- 0. � 200 Main Street, Hyannis,MA 026011111 ��� a- Office: 508-862-4644 Fax: 508-'30-6304 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 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑, CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 .� VI CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charize of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?_YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. s / 4. FULL NAME OF APPLICANT: Sene- 5. /L p NAME OF ESTABLISHMENT: Dew%Uzs o 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: -7 9. EMAIL ADDRESS: 10. SOLEOWNER: V YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHO #OF: CORPORATION NAME :9pAj? Mk c-&A PRESIDENT TREASURER PV n•� CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT Va DATE J Q:\Application Forms\HAZMAT APP 2017 REVISE . ocx c u*) s- Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis, MA Is Hereby Granted a License' For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. -------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable • � ►o,,, Regulatory Services 0 Richard V. Scali,Director `"AAA & Public Health Division #®R 1639. �0� Thom as McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-Ir APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 68, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY Ist—TUNE 30th). APPLICATION FEES CATEGORY 1'PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 D4 Y'b CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ . A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE ` FULL NAME OF APPLICANT: 2�1n01�V 'CS NAME OF ESTABLISHMENT: 1� C��C�Y1ei� ADDRESS OF ESTABLISHMENT: 0 (-O 9J, y)� MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: �`� EMAIL ADDRESS: SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADD SS,AND TEL PHONE#OF: CORPORATION NAME PRESIDENT nLs; ai 9- 6 W n6 n . TREASURER Y CLERK Q ►1n i n 1^� Ci • IF PREPARED BY OUTSIDE PARTY: SIG T to F APPLICANT Name: Company Address Telephone#: Email: Q:Wpplication Forms\HAZZAPP Rev I6.docx Page I of 2 I r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 errs Public Health Division Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $125.00 (Check) on 6/9/2016 Permit number: 1059 i ;Check number: 35940 Check amount: $125.00 Name on check: Spartan Cleaners I Business: Spartan Cleaners Owner: DENNIS Address: 242 BARNSTABLE ROAD, Hyannis _.__ ....._ .....-.......- ._..... ._....... I Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------I----------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health t• • • _ Town of Barnstable °FtHE ram, Regulatory Services Richard V. Scali,Director MAM Public Health Division 'OrEn �a 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. J ` 616 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS ` �(' FULL NAME t�OF APPLICANT �.�,1�(1� ��o. U ko's NAME OF ESTABLISHMENT • ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER: V YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. aqr? L4-S1 STATE OF INCORPORATION . FULL NAME AND HOME ADDR�S OF- PRESIDENT �.� e,Y\h is �, TREASURER CLERK nl� • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# �;b 38 e-q3 q8 0 C:\cache\Temporary Internet Files\OLKD3\HA7.APP ReQ015.DOC I ' Office: 508-862-4644 Town of Barnstable . ~ Regulatory Services Department' Fax: 508-790-6304 ;. BAAriM' Public Health Division Mom. Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt !Hazardous Materials Payment received: $100.00 (Check) on 6/15/2015 Permit number: 1059 iCheck number: 35622 Check amount: $100.00 Name on check: Spartan Cleaners I (Business: Spartan Cleaners Owner: DENNIS Address: 242 BARNSTABLE ROAD, Hyannis i Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., 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 rI r Town of Barnstable °ptME Regulatory Services ti • °� Richard V. Scali, Director BARKA LF, Public Health Division ArEo �°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. 3�'a ''bJ DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �.�,�(t t� -�<O rAG,,S NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT �. �aK3�)2x1 1`CJ o nl> TELEPHONE NUMBER SOLE OWNER: 4ES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. U 'rI STATE OF INCORPORATION Ws FULL NAME AND HOME ADDR ,S OF PRESIDENT TREASURER 1:><'nn'S �dS CLERK— SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 3 ' Re.)&6cA phs Lk 1 0 HOME TELEPHONE# �6 38 e=q3 q8 C:\cache\Temporary Intemet Fi1es\0LKD3\HAZAPP ReQ015.DOC v ' Office: 508-862-4644 r Town of Barnstable Fax: 508-790-6304 a Regulatory Services Department, nesnFJ Public Health Division MASS. Thomas A.McKean,CHO say. a` 200 Main Street Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: $100.00 (Check) on 6/15/2015 Permit number: 1059 !Check number: 35622 Check amount: $100.00 Name on check: Spartan Cleaners iBusiness: Spartan Cleaners Owner: DENNIS !Address: 242 BARNSTABLE ROAD, Hyannis i Number Fee loss THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., 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 f a Town of Barnstable Regulatory Services �' °• Richard V. Scali, Director 9B"M S. Public Health Division pTf1631901.MP'�a Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 941 U ASSESSORS MAP AND PARCEL,N0 ) V ATE 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 C9 Ann 6- TELEPHONE NUMBER SOLE OWNER: AS NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: Ilay r I V-V'&A Q IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0 7 ) Y STATE OF INCORPORATION C CPO FULL NAME AND HOME ADDRESS OF: PRESIDENT"D Y' TREASURE CLERK 411,, SIGNATURE 6F APPLICANT RESTRICTIONS: HOME ADDRESS1 HOME TELEPHONE# �� f Q:Application FonnsUlAZAPP.DOC =y� MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle.hazardous waste spills, etc). In addition, please include the required fee of$100..-Make check payable to: Town of Barnstable. Allow five to seven(7) working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main.Street Hyannis, MA 02601. FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division to Main Public Health Division Page Q\Application Forms\HAZAPP.DOC is Y aU Y Yi Spartan C�e���=re �, Inc. �• 242 Barnstable Road F4 Hyannis,MA 0260`1 s 508-775-8119 ItN � N F �� F CONTIN' y t � u 1F V W' ' ASTE RO"U'S I, .o F C''+� 4L'L - µ11 , BARSi�E POLICE- DEPT' � � � t � w v�08=T�5-0��87 4� d HY N � � n N14 FIFE DEPT' g y �'S-1 01 t PVB'LL ;11 „ EALTH t„. O � i , HAZARDOUS-WA `H� �' �� US WAr�`�E v. �., �; t y ,., � F � { 1 DEPT'. OF ENVIR Irll; , ON�� : PRO' E•CT'ION 1 i¢ s� 05'I�iA. ALA' T `S C2 M tx VTR '�£� ICi :_:I 12 n '' ' 7 Mj biZ I 4 t y r � S i i j INu4`I �f } -' 5- INC.iY Y l0 1F. imothy Lavelle �` ' 'HE�COMMONW,EALTH OF IVIASSACHUSETT'S o Hazardous Materials Specialist ' r1, > � 'ARTIUItNT OF p'�1B�tC =SAI=�ET"Y Town of Barnstable } f 'PEE' rRTURNfiINf 5 DAY$•IF'iNOT C<ALt. ,D F 'R,>• ma Department of Regulatory Services r �, , b` i Q TO. Pt�•� b �.'C�RM`ACIC STAR OFFICE BI ILDFN.O Public Health DivisionASHB`U'RTON PLACE 1�3TH FLOOR lours 200 Main street,Hyannis,MA o2sotO.ST,ON, MAS.SACHUSETTS 0;21^"08-161i8 �t,. i•nn„,., Tel: 508-862-4645 n M— `. ^n'I Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------------------- ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health �r t L f A Tow of Barest-.-ble 0 1ME R€gal2tory Services Thomas F. Gefler,Director 1 3 a 3 AA R1Vc7 aAT.T1 Public Health Division of A CS. 7 a? a Thomas McKean, Directnr 200 main Strut, H7=is, MIA 02601 Ofkz: 508464644 Fes: 50&790-6304 Anpiication Fee: $100.00 ASSESSORS MAT AND PARCEL NO.��g o/ � DATE 1 APPLICATION FOR PER1NET TO STORE AND/OR.TTITI,T F MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NA2�9, OF APPLICANT ���� Karole�as -N-_ + OF ESTABT,7, fEI�7 � 1 ADDRESS OF ESTABT,7G]�'T TELEPHONE NUMBER NJ o SOLE OiIl3:✓ YES N0 , . C> IF APPLICANT IS A PA.RTN-, =,F-=NAB AND HOSE ADDRESS OF ALL v co PARTNIRS: -� I .. co co M i .. EF APPLICA�'T IS A CflI3.P033ATI0N: FEDERAL IDENTIFICATION YO. STATE OF INCORPORATION �� �,'�-y YULL NAME H01 12 ADDRESS OF: ?RESIDENT ��5 �t,�" � 1 SIGi tA=OF AP11LIUINT I RESTRICTIONS. HOB ADDRESS. HONI TELEPHONE ` Y i Fazdadwp/q I 1�1�AIL- IN REQUEST S Please mail the completed application fo= to the address below. In addi-Lon, please include the 1e zd fey amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstuble Prablic Health Division 200 main Strzet Hyannis, SSA 026,01 FOR FAXED REQUESTS Olz fax -0,12mber is (508) 790-6304. Please fax a completed application foam. In additon, you must mail the requi ed fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The chec-k must be mailed to the address listed above. For frffier assistance on any item above, call (508). 862-4644 i i . i II j � j 322- c)to THE T Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RnRMASS. ,$' 200 Main Street• Hyannis, MA 02601 " ,bM e MA'S ,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 Business Name: Date: y`Al Location/Mailing Address: Contact Name/Phone: Inventory Total Amount: �� _ MSDS: License#: 65,19 Tier II : Al 11 Labelina Spill Plan: Oil/Water Separator: Cb0 -Floor Drains: Emergency Numbers: Storage Areas/Tanks: 0419,06 +-Jr-gar e 14 um Emer enc /Containment E ui men# s Waste Generator ID: NU1144Waste Pr duct: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECO MENDATIONS: `W 'm— Inspec Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS i Number Fee 1152 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CARPETS OF CAPE COD 239 BARNSTABLE ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------- ------ C� WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I rr r 12 Town of Barnstable ��► ►�,,,ti Regulatory Services Richard V. Scali, Director MAMCAB Public Health Division BARNSTABI, 1639. 10� nns"""soxsA°r�osreanuFmws°i'"eax"�s'nss `. Thomas McKean, Director 1639-2014(\J`ry11 � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-630�;` �i APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE Y. 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 ❑ . A late charge of:.'$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. (PO-g DATE LA (p FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT:�, .a'Cocts CIF Ca c e.CCU and VYy�re_ ADDRESS OF ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: " �'��' LI a (Q EMAIL ADDRESS: , )Olo C to (T ,C'nd _cmc) SOLE OWNER: YES ✓NO IF NO,NAME OF PARTNER: M,C hOA Z _A,4e_, FULL NAME,HOME ADDRESS,W TELEPHONE# F: CORPORATION NAME r1 Y� PRESIDENT W— ' TREASURER Li bogy—. , CLERK Mj Q C18.jL Li • IF PREPARED BY OUTSIDE PARTY: SI NATURE O A P P L C A.NT Name: Company Address Telephone#: Email: Q:Wpplication FormsViA=APP Revl6.docx Page I of 2 Number Fee 1059 THE COMMONWEALTH OF MAS.SACHUSETTS $loo.00 Town'�of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., Hyannis,MA 02601 Is.Hereby Granted a.License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/201 o JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health J I .1 ' Town of Barnstable �pFIHE rpk� Regulatory Services ° Thomas F. Geiler, Director • + BARNSPABLE, PublicN1ASS. a ublic Health Division ArfoMA�a' Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO.2(9y--Lo it) DATE jem D� ! 1. Lf c�O APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT \ ADDRESS OF ESTABLISHMENT.:,O Y n S • TELEPHONE NUMB R �� ���`��� 5 SOLE OWNER: YES NO .; IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF.ALL PARTNERS: 'a IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Y ySp� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: TREA SERER `L � ,r � is CLERK � ri . SIGNATUR APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE Haz.doc:kk p'y cc 9 ea -Il Flpn f,L numlxres PrnSd' 0.i de. yrte:9 �CRL �J has-�ec� �vr� A-,., �rL� �Q v�� Spartan C Ceaners Inc. 242 Bamstable Road • Hyannis,MA 02601 508-775-8119 C � 276' a3g wog 7 � n csz � c�.r� 5 I� o po :s �' ►�� � .- moo$ � ���= �30� ivisibn 61 c. LAA--\ D � �,►-�.s c.�.��-sue- , ��o� `� �3� vl r o:/1 r1l e,lk t. I Lo&gl_ {v 17 ,5(� (o qa,C) H 1 A+i ono L �'86� 3;� 1— 6 7 SA 0 • iFORM DPS•10W THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC SAFETY RETURN IN 5 DAYS IF NOT CALLED FOR,TO McCORMACK STATE OFFICE BUILDING 1 ASHBURTON PLACE -13TH FLOOR BOSTON.MASSOC14IIRFTTt4 A91(I unit i r,rr.-. - - .w..r•..ax+d+mli.4ufr� '2.M 1' j R " FIRST AID ex HEDicAL TREATMENT F` i Inhalation Contact with Eyes 3 Response to inha- If liquid perc has entered the eyes,wash lation of perc va- them promptly with large quantities of por at various water for at least 15 minutes. Consult concentrations a physician as soon as possible. varies among different individuals, and even in the same individual depending Oral Intake upon his/her physical condition. Mild side effects due to brief overexposure If perc has been swallowed, do NOT to perc may be manifested by light- Induce vomiting. Never give anything headedness, incoordination, dizziness, by mouth to an unconscious `headache, mental dullness, sleepiness, person. Seek medical attention imme- • and possibly nausea. Perc is capable diately at the nearest hospital emer- of producing an anesthetic effect if gency room or from a physician. massive concentrations are inhaled. Diagnosis of Perc Exposure The most important action following overexposure is to quickly remove the The diagnosis of pert exposure can be patient from the contaminated atmo- established by breath or urine analysis sphere into fresh air. If breathing has up to several weeks after exposure, ceased,start artificial respiration. Ozy- depending on the amount absorbed. gen may be administered by qualified Analysis may allow estimation of the personnel. Keep patient quiet and magnitude of the exposure, and the warm and get medical attention at once. likelihood that poisoning will develop. The technique of breath analysis is rapid Skin Contact and easy to perform with the proper ' equipment. All contaminated clothing and foot- wear should be removed at once an not worn until thoroughly dry. Was;, affected skin areas with large amount of warm water and soap. Consult t E �f Y �I I r `- - -- FIRST AID ax MEDICAL TREATMENT Inhalation Contact with Eyes s Response to inha- If liquid perc has entered the eyes,wash lation of perc va- them promptly with large quantities of por at various water for at least 15 minutes. Consult concentrations a physician as soon as possible. varies among different individuals, and even in the same individual depending Oral Intake upon his/her physical condition. Mild side effects due to brief overexposure If perc has been swallowed, do NOT to perc may be manifested by light- induce vomiting. Never give anything headedness, incoordination, dizziness, by mouth to an unconscious headache, mental dullness, sleepiness, person. Seek medical attention imme- • and possibly nausea. Perc is capable diately at the nearest hospital emer- of producing an anesthetic effect if gency room or from a physician. massive concentrations are inhaled. I Diagnosis of Perc Exposure The most important action following overexposure is to quickly remove the The diagnosis of perc exposure can be patient from the contaminated atmo- established by breath or urine analysis sphere into fresh air. If breathing has up to several weeks after exposure, ceased,start artificial respiration. Ozy- depending on the amount absorbed. gen may be administered by qualified Analysis may allow estimation of the personnel. Keep patient quiet and magnitude of the exposure, and the warm and get medical attention at once. likelihood that poisoning will develop. The technique of breath analysis is rapid Skin Contact and easy to perform with the proper equipment. All contaminated clothing and foot- wear should be removed at once an j not worn until thoroughly dry. Was, i affected skin areas with large amount :' of warm water and soap. Consult as Yam• - � $ �� ' i�, � $�+"��� � �1 4Y'.+ �{ 5- ,ys+ ton�'f f�'•„' r syy. tns�s y Wig'-, Ith solvents This poster pertains to DOWPER` solvent (perchloroethylene) as used in the drycleaning process. Perchloroethylene is safe to work with when you handle it properly. To protect heaath and environment, read the Material Keep the work area well Safety Data Sheet (MSDS) and see your employer forF f ventilated at all times. Looal exhaust ventilation information on safe handling and first aid. may tie necessary for some operations. ' rRg Watch for any early danger t h warrlings of overexposure, 5i ` ,. including eye,nose or p throat Irritation,dizziness, M sickness;or strong solvent detected,vacate She area;and report it to " rsyour supervisor. ,,,�Always wear a respirator 7 `eq'6!pped with a fresh x t k cartrid a protective eye oreathe excessive t 9 `p - ¢Avoidbreathing wear and:gloves in the re of� .- ,- : r, event of a,spill or when .' Y r 1, bditoentratlon " potential for direct solvent , i Wnti8t&sts. s '""• ^' "!"'°O;; DOW EMERGENCY RESPONSE NUMBER: Follow confined area entry .7pr&edures(ASTM 4276)• 1-409-238-2112 �r,Get.approval from your y T ' 't use solvents near For non-emergency situations and additional g tsuPervisor.before entering rise heat sources, ty ""i s,,ln rescue situations,wear information call your Dow product steward. a confined area where \ nvelding Or-electnc arcs. F Aprotertive equipment and ' vapor may be present. 3 bum or cut an empty ; remove person to fresh air. 4 Always use inside/outside 3 sofvent drum with a torch. ��� f � " twoVerSon team. `_ ,� �,t"y w.. n z NOTICE TO EMPLOYER:If you employ any non- z- y � Preventilate and continue - English speaking employees,explain this safety r to ventilate while inside. k ',p wall chart to them in their native language. The illustrations should serve to remind them of the safety points. Clean up small spills r quickly•turn on exhaust3grt t dispose of solvent ' ventilation,wear appropri- Wastes by pouring them 1 * ' - Immediatel administer t r - -ate'safety.equipment and fan the ground in sewers, $artificial resuscitation if k:up solvent using an �iocaWumps of-imthe soa Responsible Care' � e the,person is not breathing. Good Chemistry at work iabsorbentmaterial. Put rsuPPIY Preferred Have someone call for used-absorbent in a closed, votions include disposal •+ medical.hel NOTICE:No freedom from any patent owned by container and dispose of by licensed reclaimers or j P` Seller or others is to be inferred. Because use "a 1: ro a Note:For large perriiitted mClnerators.) n conditions and*applicable laws ma differ from p p. � 9 `S'� + Y �� ; vspillS;eveeuate,.use m� one location to another and may change with i d} as w 01confined area entry ' i a, k time,Customer is responsible for determining procedures for cleanup. �,� k' ¢ - DO NOT;induce vomiting. whether products and the information inthis t'JOft.'t BrnOke Or eat'in CalG:" ctor.whenever document are appropriate for Customer's use and for ensuring that Customer's workplace and f b USe'sONent-free fresh air Work area. xi, a solvent has been. disposal radices are in compliance with a h ew'a �.i., 3 r P P pPi- h for combustion and provide swallowed. p 41. o t^ cable laws and other governmental enactment. adequate ventilation to Seller assumes no obligation or liability for the tkeep solvent vapors from In the event of solvent_= information in this document. NO WARRANTIES a fhl h heat =. i, ? T)WA store solvent in. ARE GIVEN; ALL IMPLIED WARRANTIES OF 9- contact with the eye,flush MERCHANTABILITY OR FITNESS FOR A PARTIC- ebeled or misiabeled e Immediately with plenty of ULAR PURPOSE ARE EXPRESSLY EXCLUDED. Contetners d Clean all contaminated �> d water. Then seek medical k ' IM4 clothing or,protective $� r' w _�rrx bAttention + equipment until it is completely clean and dry r �;, r - p, ,� r --, 4 fir " "3� • ` 'before wearing again. + p Discard leather articles Don t swallow the solvent. ex� w Wash the solvent from such as belts and shoes. '+ N _ M the skin + •>_ Printed in U.S.A. 100-06672-1101AMS �• r IR #-` Trademark of The Dow Chemical Company i r" DRYCLEANING AND LAUNDRY,y REVIEW EXERCISE � : 1 'c � Name i ,2� L1 yJ 4,n Z Fill in the Blanks 1) You have a "Right to Know" because you work with P-62 4(Z� materials. 2) The employee must read the (20Vu0- labels and Data sheets and follow the instru tions. 3) Prolonged c O"'T-19Ci— with some drycleaning and laundry chemicals can cause dermatitis and possible internal injury. I 4) The product Me DS will tell you what p you will need for the specific material you are using. True or False — Mark T for True or F for False 1) '� Accidents can be prevented by keeping a clean and uncluttered workplace. 2) i� It's okay to over-ride safety switches on the hot head press if you're in a hurry to get a job done. 3) You don't need to turn off the power to a unit with moving parts, such as the conveyor, while cleaning the unit. 4) Care should be taken when working with any of the drycleaning units that use heat and steam. 5) _ After removing the filters from the filter unit,'the filters can be left out to d ry. t Circle the Best Answer 1) osure to hazardous drycleaning chemicals usually occurs when: agExoring chemicals b) loading and unloading drycleaning unit c) receiving a new supply of chemicals 2) In case of a chemical burn, flush skin or eyes: (Dbr at least 15 minutes b) until your supervisor tells you to stop c) for 10 minutes 3) Storage information is found on: a) the storage cabinet b our supervisor's desk c) e product MSDS 13 Copyright 1989 American Hazmat Inc. Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., 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 SAW AYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health as I Town of Barnstable Barnstable jMME rti Regulatory Services Department !� M-M,erica city Public Health Division + BARNSTABLE, ' NAM ��� 200 Main Street, Hyannis MA 02601 '°rEc 39. 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 <PK?,&PrS NAME OF ESTABLISHMENTIFI ^� ADDRESS OF ESTABLISHMENT TELEPHONE N ER /� 1 SOLE OWNER: YES NO IF APPLICANT IS A PART ERSHIP,FULL NAME AND HOME ADDRES F ALLF PARTNERS: �j cn O � IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION_ 1 1 I FULL NAME AN �HyO�ME ADDRESS O PRESIDENT � S AO-3 TREASURER CLERK W SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Loh,c, Wts� HOME TELEPHONE# R33T- -OP(OU Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., 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 i Town of Barnstable Regulatory Services . Thomas F. Geiler,Director ' KAM. g' Public Health Division .63ga 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. —lJ _V 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 _� _ _y� 7_ .__ _ : �5' __. ►7U'It� .TELEPHONE NUMB SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: C N �. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION w FULL NAME AND HOME ADDRESS OF: . rn PRESIDENT '' 'bP ql()1 S kq-1'l S' ,TREASURER tit CLERK"" ' r. SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS dJn/11*s HOME TELEPHONE# — Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners 242 Barnstable Rd., 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. May 8, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health cr v r Town of Barnstable �aFZHe lOti Regulatory ServicesOD HP ° Thomas F. Geiler,Director Public Health Division 91A ; 6 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. -'O I d DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Den'( 1 5G�`C��Clcj NAME OF ESTABLISHMENT 6jPa`�TUY� C'' Cj)ffz .S ADDRESS OF ESTABLISHMENT Yl ,`� •. n r 'Y� TELEPHONE NUMBER _Sy� 7 �� -SOLE OWNER:IUS NO IF APPLICAN�IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: r ° Ln U_- y- IF:APPLI-CANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRES O PRESIDENT h 1 �\ . TREASURER CLERK 3jU SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Ra d,,c)At pk C40", Ve0A E d 2.6 s e HOME TELEPHONE# 8"0-9 -- 3.9 Et q%3 9 B Haz.dodwplq � 9 MAIL-IN REQUESTS Please mail the completed application, form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200.Maine Street Hyannis,MA 02601 FOR FAXED REQUESTS i Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must,be,m fled to the address listed above. Allow up to four days for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Spartan Cleaners 242 Barnstable Rd. -44 annis MA 0260f 00 M06 r) sit oa - ea r a a ra i 3'"ek }1 a i! 3a i a ! i=.€: 4liiFlt? iaii�1�FF:7i=.i'.ii1�i# _. f; r�� ��. r-'• ram' t ,I �,... ... � � �.. . .+��'• .w �\ / , ' d., <r r t 4. �: .+"" r �,,,... } �M. t�1 .. Y. r .�i9��y n. .:�; f a ..1 � } �� ' t 1 / �C Date: 5- /Z5'/ d& TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SIT INVENTORY NAME OF BUSINESS: q, n &+ tag ( �I,"a-6 BUSINESS LOCATION: 242— bAKVI.S('MW aA, 4414420-15 INVENTORY MAILING ADDRESS: it 0 TOTAL AMOUNT: TELEPHONE NUMBER: i2bg" 77 e 611-1 CONTACT PERSON: N CL O LAS KaY'u its EMERGENCY CONTACT TELEPHONE NUMBER:__6b9- 1,s Z '15)42 MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: - LIZ A19k Fire District: . tWaste Transportation: p�f� Last shipment of hazardous waste:Name of Hauler- Destination: Waste Product: Licensed? es No NOTE: Under the provisions of 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. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. 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 v 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, Misc. Flammables 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 (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r✓. OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE ANITFREEZE GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM I ( X (GEAR OIL/GREASE/ +I I LUBRICANTS) oar �. FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS, SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY r7 ACID M rV� L D D GJ FERTALIZERS WASTE SOLVENT i� CAS MANIFYS-T-S D(P s- Of i iF Pat, � I x ��. . p u.�p 0 . sA � �16 x -4ao4eCW-%,��Jwadk,�Le o �tk)644 56 a6 Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS .......... DBA: Spartan Cleaners Fax: ! — Corp Name: Mailing Address Location: :242 Barnstable Road,Hyannis Street: 242 Barnstable Road mappar: City: Hyannis Contact: Nicholas Karukas State: Ma Telephone: .(508)775-8119 Zip: 02601 Emergency: (508)362-5142 Person Interviewed: ......____...........___............__._..........___........... Business Contact Letter Date: ......... ....... Category: Dry Cleaner/Laundry Inventory Site Visit Date: _.... ......... ......... Type: Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains outdoor surface drains ❑d license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc W currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir 0 on-site sewage El indoor on-site syste El outdoor outdoor onsite system 6/30/200--- 7 -- Remarks:2/21/97 Waste water cooker,eyewash station,secondary compliance: containment around marchine-new unit-2/97 MSDS sheets on site. Satisfactory Note one 15 gal.drum of perc waste. REMARKS:4/21/98-MAD 019412147 MSDS ON-SITE. Nothing is descharged into septic. Two drums of perc.waste stored in trailer. ORDERS: Move drums of perc.waste inside. 5-8-06-alp OBSERVATIONS: Eyewash station in place and hooked up,haz waste signage placed by waste perc,tray/containment around bottom of pert machine,only one person deals with the perc,employee training on haz mat. The perc waste is pumped out 1 time a week and Safety Kleen disposes of 1 time a month. Page 2 Town of Barnistable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 lbs dry or 50 gals liquid but less than 111 gals d❑ gty's 111 gals or more description qtY• uupt oi.rreasure laundry soil&stain removers(including beach) 1 1¢gallons Waste solvent € 15 gallons Misc.Combustible 3 gallons ..........__. ..._._.__... ..........__ ..._......t....._................................__m.__._.m....._.........................._ .._._..__ Misc.Corrosive i 30gallons paint,varnishes,stains,dyes 1 gallons spot removers&cleaning fluids(dry cleaners.) 90 gallons Waste Transporter: :Safety Kleen Fire District: (Hyannis Last HW Shipment Date: 3/1/2006 Waste Hauler Licensed: Yes Number Fee 1059 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Spartan Cleaners . 242 Barnstable Rd., 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 }.` Town Of Barnstable i = Barnstable Regulatory Services Department AIAMMUM • Public Health Division BA\RNSf.4BLE, 9A 1 � 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. ` Y- ,QDATE aq APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF1 KARberkasO APPLICANT i � NAME OF ESTABLISHMENT t° ,Y' l� lI ADDRESS OF ESTABLISHMENT • TELEPHONE NUMBER -5D?` SOLE OWNER:IYES NO t? , IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS',9_V ALL PARTNERS: ON� = Q w cry IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION ) `157 CI a FULL NAME AND HOME ADD SS OF: y� PRESIDENT Yl r Y` LKj .- M tt TREASURER IS C7a CLERK • SIGNATURE OF A PI,ICANT. RESTRICTIONS: HOME ADDRESSnin/S HOME TELEPHONE# j Q:\FlazmathFlaz Mat Application2008.DOC t • MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition,please include the required fee of$100. Make check payable to: Town of Barnstable. Allow time for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,NIA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc.) In • addition, please mail the required fee of$100. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page • QAHazmaftFlaz Mat Application2003.DOC Spartan Cleaners, Inc. 242 Barnstable Road � ■ _� • Hyannis. MA 02601 3 508J75-8119 F meya @hC fl UOI 1)'elr-s coy) i n eN 9ftZPCJAQ tIS WC6k �j0.\z n sAA 6�c Po I CQ- ILepi 308- �. Div i S I'bnHRZ.00-&�-, CYrAiQ an 5-08�88-�56, Lo&PL- �V, 7 _ sus _ (o qa,q N41-ML a 1- 67y a,