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HomeMy WebLinkAbout0955 IYANNOUGH ROAD/RTE132 - HAZMAT r) ca l } 1*IE OF.,.FIRM: V2tc l� i Mail to: �iAI' ING4AUURESS: �jSd' l2nvteIf, K,•A .Qz(.oi ':: Board of Health Town of Barnstable TELEPHONE NUMBER: . 72'71 - `{/ 4 2. P.O.Box 534 Ti .� I Hyannis, MA. 02601 CONTACT PERSON: Y 'Does your firm store any of the toxic or hazardous materials listed below, either for'.sale or for your'own use, in quantities' total ling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of llealth regardless of a YES or NO ,:� answer. Use the. enclosed envelope for your •convenience., If you answered YES above, please indicate ,if the materials are stored at a site other than your mailing; address: ADDRESS: -e P1,41j TELEPHONE: tJo/vc� LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities ' totalling more than 50 &allons liquid volume or 25 'pounds dry weight. - Please put a check beside each product tlat you store:�•'' .'"` wp tl7'dX-/'L Antifreeze (for gasline or coolant' systems) -_­�. Refrigerants .Automatic transmission fluid.. .,�'' ;.r .'.� ' Pesticides (insecticides , Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including bralce fluid) photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel - Wood preservatives Diesel fuel, Kexosene!, #2 ,heating oil (creosote) + Other petroleum products: grease, lubricants ,' Swimming Pool_ chlorine : "•, ,' ''_'. Lye or caustic soda Degreasers, for engines and metal Degreasers for driveways & garages "'. :; .,.' , Jewelry cleaners Bather acid (electrol te) Leather dyes y y " Fertilizers (if stored Rust.proofers ► :' 1, outdoors) Car wash detergents ; ' PCBs Car waxes and polishes Other chlorinated lrydro- Asphalt & roofing• tar �,•. carbons, (inc.carbon Paints, varnishes ptaing, dyes ;tetrachloride) _ Paint and lacquer thinners Any other products with Paint '& Varnish removers, deglosdera "Poison" labels (including ' Faint,brush c1tanerts , 3,' i, � :+; chlo�form-, formaldehyde, Floor ,& Furniture strippers `; ,.•; }' �'L t ,i; ':''; iydrochloric acidd'� other Metal polishes '; .,,�.t. , ,;r � aciis" Laundry soil & stain • removers '; " ,1:;: :'r.�;;:•' ':''' ` Tincluding. each) . 1 :�'•: ' '`�' �''��• '�'+'' Other products not listed ... `bl i i which you feel may be ` Spot removers & cleaning fluids '.toxic or hazardous leas -� (dry .cleaners ) , ;r,•:: .►' ,;.: ,' . (p e •`' ',:,, :,, ,, ,.� , �.,: ,:' ; -list): c .•1. Other Cleaning solventsNe— Bug and tar .removers Household cleansers,; oven cleaners, . r Drain cleaners : :�' '..,. '' ;':' s. . �` .,r'• Toilet' cleaners ' .• ;. " t ',� 'A �..r: t;, y Cesspool i cleaners ,,..' DisinfectantsJ, ,:t; 1�•. j Road Salt.* (Halite) i' t• r �r 4' t .t .i . r, t �.( j - ' • j �.. .r.•t� i•7 • ,y. 'r :+1r;1�•'.1•11�,(!+Y�:F^ •:r . 6.• •i .! t . .t I I 7ZO 3 Q 7L ts el r Aqv9d MAE 1 1 AleD m "11ORN!"I aut minr�t nmll xnr Ir yr 1101"Y-011jultip "t Ci w N d ;ItUMANA11 MIA A Mir "b: "Yodwil Nil tKOW-110 FISQ, , -, jo(I (I.Nr f c C-! ill�jj :Jnrj.00,.j - 011ACK10 TWA wommW! 4j AnIMM Al ) Sinai ( ! lvq! Ro ego s r t dKi -1 C.) 34. )(Y All 4L-,t r- bn I nil jug njouboIrt "nif M pufw- fir BOARD OF -HEALTH. . satisfactory 3. Auto aBodyttu shops . eQ unsatisfactory- � 4. Manufacturers / ( N ") S, Retail Stores COM%ANY 1 ( see Orders 6. Fuel Suppliers. ADDRESS Class: 7. Miscellaneous •,/���� QUANTITIES AND STORAGE (IN=indoors; OUT-outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Undetgrouad Tanks IN UT INIOUT N' S g,g l lons Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, 02 (0) Heavy Oils: Q o• I [ rAq K, VI-S waste motor oil ."(C) new motor oil (C) transmission/hydraulic o �. �ij /� '13 4-J Synthetic Organics: jMO 1'l degreasers i SQL,VE= � --�� 417 e —A c xi 0 Miscellarcas: �(p��nX� Lj 5ISP05 GEM' ION REW%RKS: 1. Sanitary Sewage 2. Wate apply, -� Town-Sewer Public On-site Q Private 45y L It 3. Indoor Floor Drains: YES NO V _ 4 Holding tank: MDC O Catch basin/Dry well N,�AB 1 �!' c ,t�l .•�l�T,1 f r _ j T` .. Q•On-site system (' t.��.Z1 I [.tG.� u�©D��.b�, MAK I 4. Outdoor Surface drains:YES N04 .— m ILs MA 1 0 Holding tank: MDC O Catch basin/Dry well OOn-site system S Waste Transporter �X ��71I�U C/.,�(Q � ��� hicensed7 Name of Hauler_ +nati nn 1oco°/t+ rodUc NO 1 u as ei a on ) nterviewe Inspector Dat16 i TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: eoa�S Iej,� L4Z-,CT*- t MAILING ADDRESS: 9 S$' re o,.�A'e L3 7- TELEPHONE NUMBER: 'y l Ll 2- CONTACT PERSON: R , L U z--� Does your firm store anyof -t} a .toxic,or hazardous_mat rials.aisted=.below; - r either for sale or for your own use, in quantities- totalling, ;at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: ion-Ad TELEPHONE: LIST OF TOXIC AND HAZARDOUS .MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals - Motor oils/waste oils Printing Ink Gasoline,, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, ' Swimming Pool chlorine lubricants Lye or caustic soda Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB s Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar q�✓ Paints, tetrachloride) varnishes, stains, dyes carbons, (inc.carbon Paint and lacquer thinners _ (� Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers drochloric aci other Metal polishes � ' Laundry soil & stain removers acids Other products not listed (including bleach) Spot removers & cleaning fluids which you feel may be toxic or hazardous please (dry cleaners ) Other cleaning solvents list.): Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite)