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1020 IYANNOUGH ROAD/RTE132 - HAZMAT
ioao yC4hn Eno Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota ................................................................................................................................. 1020 Iyannough Rd., Hyannis, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health re t Town of Barnstable Inspectional Services TABL ' Public Health Division .839•IBi4 BARN " Thomas McKean,Director ' t63y �� hw '�FONuc+` 200 Main Street, Hyannis,MA 02601 ` Office: 508-$62-464 Fax: 508-790=6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS `N IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, .4 P 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- 1 I0 Gallons: $ 50.00 ❑❑/ CATEGORY 3 PERMIT 500 0 rnore Lallans: $150 00 *A late charge of$10.00 will be assessed if t�aVment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? t/` YES NO. IF YES,SKIP QUESTION 3, I 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS.HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT; 6. ADDRESS OF ESTABLISHMENT: d 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: i 8. TELEPHONE NUMBER OF ESTABLISHMENT: 5-.-4-3 0 9. EMAIL ADDRESS: L,sgE ? m. • �g'0b•"8 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT ® , TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: , ' TELEPHONE#: - 3,990. CO A AD RESS 0"V EMAIL: 6d s rre•, S,:1 GN TUBE F VPI C A N T _ DATE 61411900A F �� ts✓,IZ �� �'�-e� � ICI I Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020 Iyanough Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 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 Hyannis Toyota 1020 Iyannough Road,Hyannis,MA 02601 TOYOTA Judy Johnson-Ulscht Customer Relations MonagerlTrac Manager -',(d)774-487-3322 69 508�771-4621 (e)jjohnson@drivepnme.com HyannisToyota.com /es)800-696-2855 1 drivepromeocom A new kind of car buying experience. Z i Town of Barnstable *g-k- 'IKEInspectional Services EINE Tn. rPublic Health Division ` C:., BARNSTAB Thomas McKean, Director , p�Ar fo�s�0� 200 Main Street, Hyannis,MA 02601 c. Office: 508-862-4644 Fax: 508-790-6304 t�= APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 �p4&hV-:4r 4/0$8(a- *A late charge of$10.00 will be assessed if payment is not received by July 1st. /OV1 -/L 1. ASSESSOR'S MAP AND PARCEL NO. / � 2. IS THIS A PERMIT RENEWAL? c/ YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS, INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: n-71S �Wh� ?- 5. NAME OF ESTABLISHMENT: / ! ��elrd 6. ADDRESS OF ESTABLISHMENT: AV 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT:- -193 9. EMAIL ADDRESS: 4022.e v � ✓� % '�- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: I L FULL NAME,HOME ADD SS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREP D BY OUTSIDE PARTY: N.AME:. J(b090)7 ny TELEPHONE#: 3- - COMPANY X DI ES EMAIL: j J'ehP5'!7 tWrl i?-1�3'f'h,Z?l�an7 /GAO /VA s U F APPL CANT DATE G F rlt Opp e do , �1 SNumber Fee s 159 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020Iyanough Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------- --------------------------------------------- ----- ------------------------------------------------------------------------------------ --------------------------------------------------------------------- ----------------------------- ------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health i tw • • ' Tow of B ns able P� .�lc�ocfi� egulatoryVervices Richard V. Scali, Director �I"E ram, ti • �, Public Health Division BARNSTABLE s^ivasrnBr.L Thomas McKean, Director 1639-2014 Mora 200 Main Street;H annis MA 02601--_- "-- - - - Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 �L CATEGORY 3 PERMIT . 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? r/ 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 QU�ANATITIE�S(25 GALLONS)? AYES NO. 4. FULL NAME OF APPLICANT: _` 'I -Cc ►)N� L L - 5. NAME OF ESTABLISHMENT: S / V �� �A 6. ADDRESS OF ESTABLISHMENT: / 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: �"�- ` r � ��(✓�/ n-G�`'l� C C� i 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDR��,AND TELEPHONE# F: CORPORATION NAME f'/C1P\4C- ^A0 TTOAIZ PRESIDENT L�9 V l o-S FN E (- TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT r DATE r 09 /y Q:V.pplication Forms\I-IAZMAT APP 2017 REVIS D.docx s Number Fee 15s THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health J_ This is to Certify that Hyannis Toyota S4 1020 lyanough Rd., Hyannis, MA — - --- -__--------�— Is Hereby Granted a License PQ For: Storing or Handling 500 gallons or more of Hazardous Materials. ---------------------------------- -- T' --------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 wA of B instable egwatory Services ]Lhard V. Scali,Director Pu ilic Health Division ! BARNSTABLE �i - � xxStaiut•vxvu.e•eorurt•xrar.r:rs ]IM NSPABIX HrAss Thomas cKean' Director ! •,�-�,-.°]�•w,5"<=x6*awt 639 �4 9�grfo d`� 200 Main Street, Hyannis,MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTh IZE RAZARDOUS MATERIALS IN ACCORDANCE WITH THE TO"OF BARNSTABLE GENERAL ORDINAN E, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED T OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). i h' APPLICATION FEES " CATEGORY `PER1VIT `26-'110`Gallons:' ' $50:00 0 CATEGORY 2 PERMIT 111 -499 Gallons: $125.Q'O � CATEGORY 3 PERMIT 500 or more Gallons: $150.Q -- *A late charge of$10.00 will be assessed if payment is not received JuIv 1 t. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? V`' YES NO. IF YES, SKIP QUESTI N 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUS SS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUSMATERIALS STO GE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES —(25 GALLONS)? AYES ; NO. 4. FULL NAME OF APPLICANT f l r l �✓�� �" i 5. NAME OF ESTABLISHMENT: YYA U-7—A 6. ADDRESS OF ESTABLISHMENT: /O —�- /' /�' O N ", Y�T��U. i 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S69) � :S s 8. TELEPHONE NUMBER OF ESTABLISHMENT: /,. 3 9. EMAIL ADDRESS: Gv " .L i 10. SOLEOWNER: YES NO i F NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD SS AND TELEPHO #OF: CORPORATION NAME 1 I G- �(0TZAZ G�cY\j PRESIDENT 0 S E IQ EV?,G- i TREASURER i CLERK j i 12. IF PREPARED BY OUTSIDE P TY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: i SIGNATURE OF APPLICAN ,� DATE -7 00 1 Q:\Application Forms\I-IAZMAT APP 2017 REVI SED.docx ! i i i °F1 fob Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAq . • 200 Main Street• Hyannis, MA 02601 �OrEDMn+p,O� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: YOLv\.Yk, 6 I o o Date: IQ 16 Location/Mailing Ad ress: loq O -r i oz.o b-ug 1 _ QW, 4 r Got- �s — 4n✓Ie � Contact Name/Phone: 12 0 1 Sot3--73 - 3 5— ;6e<J,G- MA.-a1 4 - at+ O'eo�ru-�1 Inventory T t I mount: A l (44es?a9 MSDS: 2 License#: Tier II : — ©+A I ILabeling: DkC Spill Plan: \2—S Oil/WaterSeparator: a Floor Drains: S Emergency Numbers: eS Storage Areas/Tanks: ee-- t5 av` o 3 i 1 vtg tk-,m• < t CI-I L s Emer enc /Containment E ui ment: �'�� (t" ®o ° m w.�Ga Waste Generator ID: DDOIB 8 Waste Product: Or 14em, AXIS S61v,--vc�- Date&Amount of Last Shipment/Frequency: V11 oov 1 1 X wae4. I r 2- x r Licensed Waste Hauler&Destination: C o� ck M Other Waste Disposal Methods: y°IvXe- c-A5 e- -e o4,1 91 -4i, JA,al6v ova,Ads o�� wg - ►X ��ht ww5 LIST OF TOXIC AND HAZARDO S MATERIALSf 0 Nu�q o C A c� NOTE: Under the provisions of Ch. 111, Section 31, of the Aeneral Law of MA, hazardous naterial use, + tti,}e;K}c, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 5ktl�_tl;l 573f��1 . 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/RECOM MEN DATION& owe-t s o S a Sf��• J Iti t0., c . �otti C Ll. C. Wt1Gq,l c'ovWt,�Qe� +,2, ��- ,�t�,ti Gt,,a w�, I / Inspector: •C n�3$O d 't Facility Representative:�2z /I V Pa?k2h5k 7�sly a WHITE COPY-HEALTIIDEPARTMENT/CANARY COPY-BUSINESS ,ME*ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA `�' 200 Main Street• Hyannis, MA 02601 1659. �OrEDMP+°`e� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: &Kvt 1 S o o A- Date: 77 Z I y Location/Mailing A dress: 1d +- I 2a T arAd j•- 12 tAyo eAr.waA a.� ios 20'etc> k Contact Name/Phone: SutffL-l)in 5103-77 S 1;L30 0-C-11 �reo S-737-y �"J L Lc —InventoryTotal Amount: MSDS: 1-5 License#: Tier II : .Lt Labelina: oo Spill Plan: Yes Oil/Water Separator: YPLS Floor Drains: CS 7 005 Emer enc Numbers: Storage Areasfranks: Uik ov, ,e keu.� 5 k vawt A,P,z, 2 5 13 Emergency/Containment E ui ment: wI I Waste Generator ID: i�'D000 ,0 2 Waste Product: 01 . �vl}e��,c.K���iee , Ae�c�s c�t►�e,r Date&Amount of Last Shipment/Frequency: 6'14 SOD a.l V11 ti �— Licensed Waste Hauler&Destination: CA Vt M 9. 50 -7? Other Waste Disposal Methods: Her, -C,r $ a I Cleo kFm,r ask �leaK.ef LIST OF TOXIC AND HAZARDOUS MATERIALS N p y b.(cka `j t k 1 v�.1�ko,C NOTE: Under the provisions of Ch. 111, Section 31, of the Uneral Law f MA, hazardous ma erial use, 2/5113 �- 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 V Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil �� Refrigerants vl Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides �— Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) V 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 V 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 OMMENDATIO S: vl�- q S d"fe �- Gt �► C7 / �-1 OVycx,Q I OJI Cep Inspector: L.11V& Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020Iyanough Rd., Hyannis, MA Is Hereby Granted a License — For: Storing or Handling 500 gallons or more of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ----------------------- ---------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J:CANNIFF, D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r l4, '28. 21,16 4:58PM HYANNIS TOYOTA SERICE k 7965 P. 2 Town. of Barnstable �x Regulatciry Services �( • �; Richard V, Scali,Director b� `� BABSTABLE Public H Division „ L ¢ 1 Health D>1�'jSl Ol{ p�pp++/ygC•ClNl6R ll'.a1lyylC•mqq v)) S �W`u6 ilL)•O1iS1lL!•liR jlA3j'lg; Thomas McKean,Director 200 Main Street,H awiis MA 02601 Office: 5W862,4644 Y 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 A\T ANNUAL PERMIT(RUNS JULY 1st—JUNE 50th). 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 1!0 A late charge of$10.00 will be assessed if Dayment is not received by July is , ASSESSORS MAP AND PARCEL NO. DATE • FULL NAME / (f0 v-J'J F-"-- OF APPLICANT: /`zd1"/�� GI NAME OF ESTABLISHMENT: !1 I J�JT 7Z V0 ADDRESS OF ESTABLISHMENT: 0 D O 4 , MAILING ADDRESS TELEP11ONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: r dCon� rc L� d�'�v Ply _ 6v SOLE OWNER: `AYES NO IF NO,NAME OF PARTNIER: FULL NAME,HOME AD77rAA!SS, D LE�;HONE#OF:' CORPORATION NAME L�r N fir- L L C_ PRESIDENT � TREASURER CLERK IF PREPARED BY OUTSIDE PARTY; S OF APPLIC NT Name: Company Address i'►'1Oca�vn►rC.���sl��.p,rlme.o co� Telephone#: C,\UserslmoconnelllAppDatalLocality(icrosoftlWiadum\Temporwy Internet FilcslContent.OudooklR70UJ1DOIHAZZAPP Revi6(2).0ex Page I of 2 �\ Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020 Iyanough 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 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 Regulatory Services Richard V. Scali,Director BARNSCABLE, #MASS. Public Health Di Ej ^ vision i639• �� irz:,. pIFDMA'�° Thomas McKean,Directors 200 Main Street, Hyannis, MA 02601 UTI Office: 508-862-4644 Fax: 508-790-6304 =X: Application Fee: $100.0.0 H�, No ASSESSORS MAP AND PARCEL NO. �% DATE ( / � APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANTU k ! '� NAME OF ESTABLISHMENT f(A.� • ADDRESS OF ESTABLISHMENT r -- 7 TELEPHONE NUMBER ( r. SOLE OWNER: /YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION I FULL NAME T HO DRESS OF: PRESIDEN / TREASURE CLERK • SIGNATURE OF APPLI" T RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# C:\cache\Temporary Intemet Fi1es\0LKD3\HAZAPP ReQ015.DOC , r Town of Barnstable Office: 508-862-4644 ,c �4 Fax: 508-790-6304 a Regulatory Services Department y�yKyfS�yr,. //�qj, * Public Health Division � 241'Jl�iteJy M _.. MASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt 'Hazardous Materials Payment received: $100.00 (Check) on 6/12/2015 i Check number: 3402437 Check amount: $100.00 Name on check: Prime Motor Group IBusiness: Hyannis Toyota Owner: AMR REAL ESTATE HOLDINGS HYANNIS LLC Address: 1020 IYANNOUGH ROAD/RTE132, Hyannis • I Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020Iyanough 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 6/15/2015 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 - Town of Barnstable °F1HE 1p Regulatory Services a ti Richard V. Scali, Director r M WgrAB I E. MASS Public Health Division 1639. ♦0 s Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT A94 A4 !GLl NAME OF ESTABLISHMENT I A 14 14 1 0 ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME.ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. K--% /i27IQ STATE OF INCORPORATION &A D� FULL NAME O AD SS F: PRESIDENT (�A/ TREASURER yl CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Application Forms\HAZAPP.DOC Number Fee 159 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Hyannis Toyota 1020 Iyanough 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 Town of Barnstable zM Regulatory Services Thomas F. Geiier,Dires:tor a � i Public Health. I)iTision 9 Thomas MCKEaI4 Director 200 Main Strut, Hyannis,MA 02601 Fes: 508-790-6304 Ofi�ca: s08-86?-4644 Appfica#ion Fte: ASSESSORS jNLAP ACID FARCEL NO. DATE STORE �PLIOATIO-N FOR PERMIT TO � A� /OR ZTTM= 1MORE THAN 111 G_AUUNNS OF HAS, QUS 'MA.TERLA_LS FULL NAME OF APPLICANT NAME OF ESTABI��r AM rrn ► _ T It � ��� fA l VIS ioyo7'14 ADDRESS OF ESTABLLgMIVf 07 TELEPHONE N-nSZR — 7 — SOLE OVVNMT.: YES N o LF APPLICANT IS A PARTN ,FULL NAME As�i7�HOME ADDRESS OF ALL PARTIN-YRS. 11 APPLICANT I5 A CORPORATION: FEDERAL IDrj=CATION NO. STATE OF INCORPORATION t7LL NAME AND EONIE ADDRESS OF: � MA TRE=ENr + 'I��_SURE� /� C ►�i iv off® �c�mr�rvu . CL= TUBE F.0-HICA U ADDREss HME Tu�r O FFS'I'RICTIONS: � HOME T THONI# i . I f MAIL-IN REQUESTS Please mail tale completed application form to the address below. in addition, please include the reed fee amount. Make check payable to: Town of Barnstable. Cur mailing address is: Town of Barnstable Public Heahh Division 200 Main Street HyamLis, MA 026�1 FOR FAXED REQUESTS Our fa;number is (508) 799-6304. Please fax a campleted application fo= L addition, you must D23E the requited fee amount (see flies at bottom of taus page). Please make the check payable to: Town of Barnstable, The check must be mailed to the address listed above. For furt$er assistance on any item above, call (508) 862-4644 I I i i i I � Town of Barnstable Hazardous Materials On-Site Inventory and Inspection a FACILITY INFORMATION: Business Name: I AWdl CG/1ZR PRISES .17 3A ,f/.V S rd G7X Business Location: /C © .J:Wk,L4th.(g6// ? ddAJ xI,UI S Mailing Address: A Z-0 � AI,Jau6 f{ o A S Telephone Number: �171- - r-75— Contact Person: 69VAAJ 4/t LLi•tIl Emergency Contact Telephone Number: &"zL 7 k' 3 7- Type of Business: 14-6t Z SA-t_45 A-,iJl-) SCR t/!'�6 �l HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc lyEP Ill C TA 6,-14 7z4 ra ICOiL_ QUA te-rs 0) ST�O AleW AAJ 17_- 6N� C��Lze,J eau7�t� ' 3 Q� 6 A-�t&OAJ S ►, W,4 ST - C 5 0 L./ &)C (7At"Xjs a/--a Al WIV b51/ z6-0 afiu4,j A5t 300 6,4U,6u AST //&W �?J1D�1 A.7JL 2 �/)330 CA-LL-O� _1;ZAWS L(Jl1) �Jv4f}LLc�,US A ^V�G 'L1�D /}W t, A-riSC, _ V�RioG�.S fLq R 1-44 13 L8—S �C�A't,Li��1s /�k`90 S6 L CA O S !ti s TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: - 4 4 GO W/t- Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: M/i P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, 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 X_ 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: 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 . Please put a check beside each product that you store: gasoline r coolant systems) Antifreeze (for gaso e o coo a y ) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners X Hydraulic fluid (including brake fluid) Disinfectants X Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel _ < Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, X Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) X Rustproofers Swimming pool chlorine X Car wash detergents Lye or caustic soda X Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes ' Paints, varnishes, stains, dyes Fertilizers.(if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business .r TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair O satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY v.�G%� �G % i33✓ O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �l. t� ��6A"''rf Class: 7.Miscellaneous 'fib �/•f�/u��� QtJANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS � 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: 2 waste motor oil (C) Z 7 �� new motor oil (C)- L/ transmission/hydraulic ZC-j v Synthetic Organics: degreasers1,y / !__� Miscellaneou : 11a eAw OSA JREC TIO REMARKS: 1. Sanitary Sewage 2.Water Supply 1i EA;- O Town Sewer ,Public 1% 4. G Von-site O Private 3. Indoor Floor Drains YES_VNO Holding tank: MDC _rt41_6 -7 or-a-i O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: , Q Holding tank:MDC - Catch basin/Dry wellAl O On-site system �. 5.Waste Transporter c , Name of Hauler Destination Waste Product YES NO 2. f :» Person (s) Interviewed Inspector Date MATE.RIAL SAFETY DATA SHEET PRODUCE'NAME: "ONE SHOT MOTOR W ,,SH6t 19110.1200 (OSHA) STATE RTK;:., ..... TYPE& USE: Solvent/Surfactant Flan Degreaser HAZARD RATING Mixture 4 = EXTREME 2 3= HIGH HEALTH 2 ., 0 REACTAATY MANUFACTURER: 2= MODERATE , , TRANSMATE . PRODUCTS Inc. 1 = SLIGHT Elan , 0 = INSIGNIFICANTiJ i 13 STERLING RD.P.O.Box 343 &PFCi IC NO. B I LLcR I CA MA 01862 HAZARD EMERGENCY PHONE: 617-667-0100 DATE: 4/20/87 SUPERCEDES: 5/25/86 BY: AER WARNING DANGER HARMFUL OR FATAL I F SWALLOWED. COMBUSTIBLE. STATEMENT CONTAINS PETROLEUM DISTILLATE VAPOR HARM FUL. a PETROLEUM SOLVENT (Stoddard Solvent,Mineral Spirits) CAS ##8052-41-3 c& :i5; ACGIII/OSHA TLV/PEL 100/100 ppm.STEL 200 ppm.Mfr , tox.LDS ' over 5 g/kg (ori-rat) NONYLPHENOXYPOLYETHOXYETHANOL (Nonionic Surfactant) .CA.5 ##9016-45-9 0a % HAZARDOUS ACGIH/.OSHA Not Listed. NIOSH Li) 2540 mg/kg (orl-rat). Severe Eye Irritant. i 50 COMPONENTS 2-BUTOXYETH&40L (Ethylene Glycol,Monobutyl Ether) CAS # 111-76-2 ca-3 ACGIH/OSHA TLV/PEL 25/50 ppm.STEL 75 ppm (skin).NIOSH LD501746 mg/kg"(orhrat) i Current Data Indicates Solutions Less Than 40% Pose Insignificant Skin Hazard. MSL OTHER COMPONENTS ARE NOT CLASSIFIED HAZARDOUS l3E NA-1JRE OR CONCENTRATION. SOILING RANGE: 220-400 fF DENSITY: 0.95 g/ml; 8 lb/gal VAPOR PRESSURE: ca 15 mm lig 7.0'F %VOLATILE: ca 80% +<< PHYSICAL VAPOR DENSITY: 4X Air (Solvent Phase) ' EVAP. RATE: ca water DATA WATER SOLUBILITY: Soluble/Dispersible pH DATA: 12.8 as GEfVEFiALAPi'EARANCE: C;lear,Amber,Viscous Liquid. Mild Solvent Odor. FLASH POINT: 114'F SETA CC, AST_M D-3278 FLAMM. LIMITS: ,��I. 4 N/D IJEL=N D EXTINGUISHING MEDIA: Use Dry Chemical ,Foam or Carbon Dioxide. Water May Be.....,, FIRE AND Ineffective However Use Water To Keep Involved Containers Cool. WaL.er Sp��.y; EXPLOSION May Be Used To Disperse" Vapors. .• OSIIA/NFPA Fire Classi.f icat;idn: +I! HAZARDS SPECIA L PROCEDURES Use Appropriate NIOSH/MSHA Approved Respirator. :? j & UNUSUAL HAZARDS� QS Protect eyes & Skin. .Vapors .Are .Heaviao Than AIr ;A„d<:�.�; May Travel To Remote Ignition Sources. EYES: liquid & High Concentrations -Of `Vapor. 'Will Cause EYe.. .rr'te�t? w c SKIN: Prolonged Contact May Cause. Drying; Due ,To ,Natural Oil Removal. I Effects of Overexposure Cause Nausea,Dizziness,Depression & Aneth,esi.c. Effect .:A o,V zvo' INGESTION: Nausea,Vomiting;. Aspiration Of Liquid May.,Cause l,.letamsa.ni HEALTH PHRONIC DATA: Liver,Kidney,Blood & CNS Diseases May Be Aggravated:'' HAZARD 1 DATA EYES: Flush With Running Watey At :Lea5t 15 hins.-GET MEDICAL All). SKIN: Wash With Soap & Water. Rem ove„& Discard ContamiDated 'Cl,at�le$.mS�p�s, First INHALATION: Remove Patient To•Fresh Air.' Use' Oxygen<If Indicated,' � l Aid INGESTION: DO NOT INDUCE VOMITING WITHOUT MEDICAL ADV7CE. GET DICAL:`AID`AAM20 li Vomiting Occurs, t1lace Patients Ilead Below Knees To Prevent Aspirat oT`!':" ACGIH/OSHA/NIOSH DATA: See "HAZARDOUS COMPONENTS11 Section Alcove No Components Are -NTP,1ARC or OSHA--Listed (Carcinogenic). (Continued on next page) N/D = Not Determined N/A Not app icat)le Les =Appfoxj ta:e STABILITY: Stabile. Will Not Polymerize. � CONDITIONS Protect Frorn Heat,Sparks,Flarne & Possible Sources ,Of. .Igpj. ,i,gca. REACTIVITY TO AVOID:, keep Containers Tightly Closed When Not In Use. Use Ventil.atio+ . DATA MATERIALS Keep From Strong Oxidizing Agents. TO AVOID: Products Of Combustion; Carbon Monoxide & Carbon Dioxide. WARN ING:Combusiti-ble Material . Eliminate All Ignition Sources. VENTILATE AREA, SPILL For Large Spills: Evacuate Area. Wear Appropriate Respiratory & PrQtective°' `" OR Equipment. Remove Leaking Containers To Open Air. .'Absorb On Clay Absorbent LEAK & Remove Outside For Safe Evaporation. Use Only Non Sparking Tools. VAPOR IS HEAVIER THAN AIR AND CAN TRAVEL TO , OTE :SOURCES OF IGNITION. COMPLY WITH ALL LOCAL, STATE AND FEDERAL REGULATIONS w All Surfactant Components Are Biodegradeable. The 'Solvent is Classed 110il1' Toxic To Aquatic Life. Do Not Discharge To Ponds.,Streams Or Wat'erway.s,.,,(¢,il� EPA/HW Classified As Hazardous Waste ( Igniteabiiit.y) 40CFR, 261 .1 . WASTE Incineration Or Evaporation Are The Usual Disposal Methods, With. PPA.Apprroyaj,', DISPOSAL Addition Disposal. Information May Be Obtained From $PA At 8.00-424-9346. i DUI' Emergency Response Guidebook DOT 5800.3 #27. EPA Regulation 40 CFR 302 Reportable Quantity (RQ) Not listed EYES: Use Splash Goggles Or Face Shield When Eye Contact May Occur. SPECIAL SKIM: BONA N Rubber Gloves & Apron. Avoid Contact With Contaminated s. PROTECTION INHALATION: Provide General Ventilation Or Explosion Proof Exhaust (60 FPM ). OTHER: Use Self Contained Breathing Equipment When TLV is Exceeded. re - 29C,R 1910. 1.34 ( Store In A Clean,Cool ,Ventilazed Area,Away From All Sources, Of Ignition. Refer To NFPA 30 & OSHA 29CFR 1910.106:"Storage & Handling Flamm.& Comb, .iq. STORAGE Clean Up Spills At Once. Use Only Electrically Grounded Handling Equipment. I AND Keep Container Tightly Closed When Not In Use. Protect Containers From„})ar}zage; ' HANDLING Always Wear Protective Equipment. Wash Thoroughly After Handling., KEEP FROM CHILDREN. FOR COMMERCIAL USE ONLY. DO NOT USE IN HOUSEHOLD AREA. SPECIAL INFORMATION CORMSTIBILITY& VAPOR INHALATION SHOULD BE THE PRIiCE CO- CERNSv. Workers Should Not Be Permitted to Handle 'Phis Product Without Proper , Pro er Training Aid, U sin 8 - Protectsve Equipment. Training BEFORE Exposure Is MANDATE B». . z9 CFI (OSHA) S.taC.e. RT . Avoid Prolonged Contact With Skin, ParticularlUnder Jewels g Y y (Watches & Rings)- & Fr Contaminated Clothing (Cuffs & Shoes), Containers Of This Product May Be Hazardous .6When "ErnQtied'° Due To Residue & Vapors, "' j Therefore ALL Hazard Precautions Given In This Data Sheet Must Be Observed,, NEVER Use A Cutting Torch On An. Emptied Container.. NEVER USE AIR PRESSURE To Discharge Container Contents. Mechanical Spraying Of This Product May Increase The Hazards (Fire & Health). , .;, Read Label Directions Carefully. Always Handle So As To Avoid Splashing. Clothes & Absorbent Used To Apply Or •Pick U This Product Ret ain T PP y h '�P e Same Hazara., of, Fire ; & Health As The Liquid Product. Take Care With Storage & Disposal. Safety Cans Are Recommended For Handling Small Arnounts Of ,Product Outside Of Original'. Container. Ground, All Transfer Containers Before Pouring. THE DATA ON THIS MSDS ARE GENERATED FROM CURRENT PROFESSIONAL PUBLICATIONS, USE EXPERIENCE AND .ACTUAL LABORATORY TESTS.THIS PRODUCT IS A MIXTURE AND MSDS FILES ON THE INDIVIDUAL COMPONENTS ARE AVAILABLE ON REQUEST. Disclaimer of Liability As the conditions or methods of use are beyond our control,we do not assume any responsibilities and expressly disclaim any liability for any use of the material. Information contained herein is believed to be true and accurate but all statements ar suggasbons are made without any warranty,express or implied,regarding accuracy of the information,the hazards co rlected with the-use of the material or the results to be obtained from the use thereof. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I I m ^ � DATA MATERIALT o AND SAFE.HANDLING AND DISPOSAL INFORIVlATION ZEP MANUFACTURING COMPANY PAGE ! CIF. 3 FIRST IN MAI7VTENANCE PRODUCTS •.:k U t"w_{'.S E..?a E_. 0•,:r ! '_..r 7 PRODUCT NUMBER: 0145 - SECTION 1 t-. M F, R G 01 11 C . Y Ey O N .ry.. A f' _ ZEP. MANUFACTURIIAG COMPANY NON-OFFICE HOURS, _t_I^i•.ND•... AND HOLIDAY& AREA CODE-404 P. 0 u!_��'t`, .2010 � 435...r:.�9 3, `7,a�?f": "'(!.;��:.)' , 252 a.5i"%.r, +.�'.: 1 1�D2, k�.r"..�j._+-1�ry2 dam 7 c c.E.,, A':�LAl��'�T A, GEl RG.{ A 30301 LOCAL POISON CONTROL CENTER ER . . . . . . . TELEPHONE (-1'0t:.}:ai,sr:. 1 6t34 TRANSPORTATION >:_.MEIY:r•E?'+:i.:Y BETWEEN%1+11:.'EN 8: 00A. M. .5: 01—P M . C LNTR: C: TOLL FREE 1 -8 C 0 4 2 , �» f f '�� �. CALLS R: COhD_ D (EASTERN TIME ZONE) DISTRICT OF COL_iBIA (c02)G83-616 -L CA. S RECORDED .._ _ .____.._..._.,_.._ . _ ___. . « -- _ ___ . . _ ._. _ _. _ . _ _ ,_. - --------- ---------------------- SECTION 11 — H A t A I'+1, D O U S INGREDIENTS TLV t=itF'w=CTra 1N DESIGNATIONS c,ESIG •!, 1 ; ON (I:a PM) (iiEaw •i'3L`v i:.RSE.�) PROD. OD. R** METHYLENE CHLORIDE ** a {:;t I y t.4.7 m e 1,A I y e 3{iC 0 J 9\v+.i 1 14 y CAR— +!t^ll"4 10120 s 1 f• .,i 1E r4 .Tr„ r:9.._2• R...'E( S ` PAS 5 t00 ,'* L a. I- ii,).rat°._OROETHAl` E ** [Par'thy wE ,f 1, ,-y5 Fr"'R• S 2 •I. 4_Ii - a'i a•I`�;; a st 1 I�.rd L>Ih-i... _.0"Sl: .> 07'ay-^i`l�+'fiF:i �.���«7•t, T a. �%:?"E.!, i"tTi'��.,,��� IA.+eye- 3!'.�•.�i`'\.: r•:** .I., 1, 2.._ I 'CH ORS 2 2 E�y r•{:air•t•"--t..,E,aE�.. .ti =s.t?i7•{,ta- .L00 I=,a! _ c.:, I �.L 1<! E._%..7. Li .., _.., c.•- i�+'.!! ._.�1a.1�� �.�1'�. ! . a-'!�asr. . ':;E4'`=+ 5^",2 0 j carbon 1 1E 3; t=r fe:a i l 1 ,y Wit; 'I`P L o f? y j,B# ��� y R r• .E_, is'f'J }.r E•1'::, :_t"" t i C:Lr;..i-Y. PARAFFIN OIL w* blend of heavy and light "aph— N/A 1RR i5_25 +.?ii:nic petrCilC llf:''I disc llIaa e; •4•.AS4 L!?'{I 42"'5A?.._5 and fF`s'.# 64 7L.w:y""'L',:.}— R ».-.S NONE; E; OSHA PS:L--N/D; A.CG J L MIST LI1.±:!...- ,mg/rf<,, . MINERAL AL. i.Fy.:.Ehif.• OIL, ** Mineral r t. •!. J . petrolatum; N/A 10 _AS# 6474 1—lr4 2; R a:_t.eS0 I':.Y+yJS,-,0 30000; A',..';I Itf{..1...H 1L E t t^fit .l� MIST LTMIT= 5t!1t,1413 � - ;r PROPRIETARY, BLENDED SURFACTANT •;r C,Ac+' f• O R, _ 20 RR _ -R J R r CS" NONE Lit-tYI._, ACETATE .n,.* acetic a1= d z ?'nt try - FBL Rr banana _ ; CAS# 5349 5 sl TEt`Si� ..> 2-ETHYL HEXYL ALCOHOL c:_..F is F y s.`"'t x 'R o l ethyl—s h bo l; G AS0 .i.0l 76 E; RTEC-S# NF03501 00; 'r _q_. T .9 � 4 E.,A i ,r�R r C .E...\ "T 3 "O ' RELEASE. dr r. REPORTING. - ' ..�.aa::1'•I t �I�' �l::_, �.t ii:.I,�. ,,r'.�....i LISTED �}Ih•+�!L1-c `aE-'r1?;1•` ,t � 9 ,��.FIa ,,,''� f_'i.x!C F�i...L.�.':,-t-__.. - ------------ SPECIAL NOTE: ADVERSE HEALTH EFFECTS WOULD NOT BE EXPECTED UNDER R 'f k +D_ ) - CONDITIONS OF USE 80 LONG AS PRESCRIBED RESC I[E } wq ._T `RL C 4 I }h 7 ARE PRACTICED: ' - rA.:'+.iTE EFFECTS �.1i' OVEREXPOSURE: INHALATION OF VAPOR " \. PRODUCE: 4 w 41-R A. NERVOUS J /S E D L" 1» . T �C" "R"C T E R l L E l - BY !%?_Z1.,Fi.NE;..S, C•{i._ADAC?'E! NAUSEA, CARDIAC E'RIhID.JOR RI.;.CPrlt.?eTORY DEPRESSION, xs tRE S _ . ON, STUPOR, . \ _ TiS/! {{OU h __ . . i DaEA9H M yXTRE7_ { A71 . . " yywUR: TO HIGH "O\• ENT TIOgP _ E,.P..rC,!R B Y DIRECT 7 [ „ _ CONTACT OR S . i p I C/ 3E IRRITATING 7R. r ING O M w OV S B R Ah« S! AS EYES AND UPPER RESPIRATORY TRACT. SEVER . r_ EXPOSURE TO . kj1ID u S CAUSE REVERSIBLE EYE DAMAGE. SKIN CONTACT r!'.'1 U••,,.i BURNING .`E ,:A I d F AND REDDENING _l ( _6 SKIN. I ) .OL\ : t7ON OF SOLVENT TO THE LUNGS, AS IN' ASPIRATION ; F - ,,-•aq•.�'-'f t - Iti}-.r:: . h.' CAUSE CHEMICAL PNEUMONIA. P SURE '•y-D I"t._;• ._. PRODUCT .! O 4 t�., .t. t t.} .: FL.=.;,.....3J MAY :-��a•..,_ �l I..._I _v=AL_ s::.,� +.��_\. r: �. THIS !-, s.I>,�:a• MAY r'•, &}S:••411Ft i p. E I._} j I{'1+ Slt...i... 4if'"%) 'RY ANb) nA RP 1.I't1 OI°'.S-'{~y }I 1l1?=`If-• .., M a.._AI;i �za..-.h"!+c.fS,. L MIST MAY PRODUCE CHEMICAL.1 CE'SL PNEUMONIA. - r;Tv fMATERIAL SAFETY DATA SHEE - o AND SAFE HANDLING AND DISPOSAL INFORMIAT ION ZEP MANUFACTURING COMPANY PAGE s_ G - 3 »- Fl RST!N MAINTENANCE PRODUCTS i\ ,a_, , r,._r ,O, "m j o o SUKERSEDE0 ,06/29/% PRODUCT NUMBER: 0145 SECTION 11 ! a i F A L. T H I_! A Z A R D +J r, 1 I: a?•y;iED a CHRONIC EFFECTS OF OVERKPOSURE: REPEATED OR PROLONGED RO _O G_D w O At BL INHALATION YH ^ ♦T1r OR C K N ABSORPTION M"Y. PRODUCE ^ «D CE I t -t ' OR KIDNEY D:^+MA00 OR Ia=FiMtAGE TO "' -E CENTRAL NERVOUS ERvO. S S . £ ce � � : r �4� :r �ed. � % sing- ling C1 TG" :n: C : 1 the i !uYt it3 ` r LlEi CI \ is . ii or confusion ) . :KINW I „ . I S t- FARTLD CY ,REP / Ti1 EXPOSURE TO SOLVENTS, 16 MORE SU_ IeL: T. IRRITATION, INFECTION, AND DERMATITIS. EXPOSURE^�' Sr SOME i '�--• S" t -r THIS PRODUCT �f i t^ CAN �, -("'_ Ai C..:.X�-t�.;SURE((^^}y(pTO SC.1;i-71E !NGi•t�.DI DISORDERS. i",S 7�'.1;\.I "f H:I:S t� 7-�•.OD�CT i,AiN AGGRAVATE EXISTING TNr: LIVER DISEASE OR HEART RHYTHM w'..fISi�i'�DERS. .DING:. OF THE INGREDIENTS I : THIS PRODUCT HAS BEEN AH^ \N TO CAUSE TUMORSCRS tAD : _ r ' :Ry TESTANIMALS. THE RELTJA Cr OF THESE STUDIES FOR Ir!,U A S HAS N`�DT BEEN ESTABLISHED. .. III S � i 'lt f:-..,.! L I• L_a_t ;L_ l: NOT� ESTABLISHED PRIMARY it - EST 'D I` CODES: HEALTH EA _T " 2 iF L2t, 1jREACT. ' `'LWi 3. PROTECT. X 4 % _ AZ. YES ... .;....__.,...._.— -."_._,._—._.._„—._._,—._,..-.,»__..-....... -- _-..-,.-... — _......-_,...............».»...._...,.................. FIRST AID PROC: D;;R S: SKIN WASH CONTAMINATED SKIN i R C -w\ WITH SOAP OR { MILD DETERGENT. 0 E :LEdT. APPLYY . SKIN CCiJii:;01 WI i T-1 3_,CxSliOL I N. GET MEDICAL ATTENTION IF !RR i. i A T I u.N PERSISTS. . � EYES WATER . "iR. �` S. . ; @� 5 IMMEDIATELY FLUSH w - ,a _ J a1 " 0 . E � : AT LEAST 15 M , i iSa OC— CASIONALLY �tG � aPPi.' ,+�•,3i` LOWER S..:t E LIDS. _S" MEDICAL ATTENTION T ONCE. ya.{ iT::LIFTING i' � � \,V Vfi..:tR /�sl,u %<,./c°.i.�_j'� �. f.;w GOT t s iG'.i.. e..-49w.. - ,� t.Sa'45.: i " l _ . MOVE rV _:"ED PERSON TO FRESH RECH A. " � ONCE. r BREATHING HAS STOPPED, PER- FORM ARTIFICIAL RESPIRATION. - _ T MEDICAL A _v I tN A L r s r - _ ' Y N`. >_ST: THIS ROUTE OF EXPOSURE IS NOT LIKELY " : TO NATURE. t0 T 1-' t t I ( , �, i 0 \ ----- ----------------------------------- SECTION (� ._.. . i'. t::J �� .T 1, i'3 �a� _i.. .r r.F i 1 i i l ivS l i y t!� 1 .�. N ,.,) 1 a., t t'i '� t 51 B .,. �.r t ... {'- � i -F , 'i -1 2. PROTECTIVE CLOTHING WEAR V s T!:N GLOVES i:=.•i tip \.I;::r:.., O._,.fVES WITH DEMONSTRATED . RESISTANCE TO i(-I i, INGREDIENTS IN 3 THIS PRODUCT. I 7 . G • _ iL RO EC °ICIt WEAR TIGHT-FITTING SPLASH—PROOF SAFETY GLASSES ' ESPECIALLY i .-,'- \a-•Par.T 9 t,t;^r;S ARE WORN. _1_ CONTACT f 6-,".�, i LENSES b..,.. � F 3:,_ RESPIRATORY -PROTECTION: -KEEP FACE AWAY FROM S :j - "r R Al MIST AND £ D NOT BREATHE VENTILATION VENTILATION SHOULD BE EQUAL TO iU` ry : . „ EXHAUST, FANS AND/OR EXHAUST HOOD ENCLOSED. SPACES. SECTION V •.••. to H Y S LC A L„ D A T A (FOR FILL MATERIAL ONLY) ). �BOIL.kNG I" OINT 4Fi I05.. 620 SPECIFIC GRAVITY 1. O {yr:,Ps_R 77E"?"S i7E .•i7;E.. G • �.'S-„2 5 � PERCENT G ,AT Y �.O;VOLUME l �� G�.3:7 . �'}, ,..•q.1a't%., �4`,. , �s` is�.rV Js__ .0 L.i:. L t...4._ kw'-A `O R D i'\`•. I 1 Y 0 1 i''1 ) , it/D EVAPORATION R hr=._i E(C C:L."-i v SOLUBILITY :+N WATER : NEGLIGIBLE PH!C.'r;w':{C .Pxl'i-;:ATE ) ;firm PH(USE DILUTION OF V114A APPEARANCE AN ti- - Al C L ODOR A CLEAR, BROWN OILY LIGUID HAVING ( STRONG SWEET ° 7Dt. SECTION V,I. ,"_ a•` S i P E IS N .) E X P 1„ 1:3 Li 1 D N :? A »I' A -L.AS!-! P01 i''a C(F) t tti:: i I-iDa1 USED) :97 NOT FLAMMABLE (Ct=.�;'Ir�) 1.,.l'h, �t"i AB L,..is L1.I`I J.,.( S }._,i._t.., Ida(p to 5..:31,..,L N/A EXTINGUISHING i`{EDSA CO2, FOAM,.M, DRY CHEMICAL i9:.._ +.rPEC.IAl_. Fa.".E +- 50l"i1 ?.NG: WEAR SEx„P. :U4ktr-'S.;\a�_.'k. POSITIVE = -S. BREATHING APPARATUS. UNUSUAL } 3RE ZATnw CONCENTRATED VAPOR MAY IGNITE j . _ X _S _3 TO SPARK. - l pumTrEIRMAL SAFETY DATA SHEET a AND SAFE HANDLING AND DISPOSAL INF01RMATION ZEP MANUFACTURING COMPANY PAGE 3 OF-' V FIRST IN MAINTENANCE PRODUCTS i i.4_ r, - L.. ,'t:al� "o AN . SU;•'E;R;:�Ef:1r_S: ijb1 - .1 c:'I '="F,ODi.}Ci' NUMBER: 0145 STAB I'Lill STABLE hN'::O1°'iPATIBIL...I.iY(t?',t ID) (,EAT, OPE:1`'.I FLAME, Si~'Aa& AND OXIT;IsrRt`G AGENTS POLYMERITATION WILL NOT HAZARDOUS DECOMPOSITION: HYDROGEN CHLORIDE, k'4;:3':=;GEi',''•iE, � :+ CHLORINE c,'Ai{.:��i - SECTION- - . '.�.;.....M.-..._...`.._.''..2.••w �..^.. -L. .»..». §.,.��__ ;_., 13 'f. S iu t.! S .A L t"' R 0 t.: E 1) U R 1+.-. 7 STEPS i...'C��'.? 1'! [.- a7'��^.C iTAKEN ^"1c1 t'S�:�.�i{ J.1-.{,�� CASE•jai;._C 7MATERIAL ;.•.•� RELEASED t 9 CSPILLED:i d OBSERVE E SAFETY Y PRECAUTIONS IN ��P::.�- I .L'.. NS '4' & 9 DURING INt_ SPILL ri.... CLEAN—UP.,�N „P. LARGE SPILLS ARE UNLIKELY DUE TO PACKAGING. SPT4 MAY. BE ABSORBED ON AN INERTER ABS ORB— � � AREA r , ( eg ZE. O _Z_RB , PLACED IN A CU [ rnstFCONTAINERLsy DISPOSAL. t;'_R0 'HLY WITH z1 DETERGENT SOLUTION AND RINSE k:,.-.4_.C... WITH W AT t R. - WASTE E DISPOSAL I't%.:.I HOD: _ PRODUCT IS ;;C3NSilfvfi:`D IN USE. O NOT i.:?4..!`_:H, PUNCTURE OR INCINERATE E SPENT CONTAIN— ERS. . CONTAINERS LARGE NUMBERS ' - �� i`_yL � AY REQUIRE HANDLING AI• A HAZARPOS - BUT IN O STATES TOTAL WASTE ;J THAN r, ' WASTE, S?V I .!.44 MOST 4 _: 1 .'S �•' t 1�L.-. HAZARDOUS QUANTITIES LESS_• 1 Y.'!i"-14\i /,�G� ���� �`��..:t MONTH MAY' �! ' rj l C't•..),,airs;_ IN A CHEMICAL �.4� INDUSTRIAL WASTE LANDFILL. CONSULT , _ akA_, STATE A7 FEDERAL AGENCIES ; 3FC PROPER DISPOSAL METHOD IN YOUR AREA. '' 002 ......_ ^:C 1 1 O�'1,4 T X �' �.�i P a I \^ 4..^ ',i- R E 't.; AU �� 1 0 , t S ' _ w `RE"CAUT 3 ONL ., TO -SE �AKE N WHEN HANDLING c"'c"(. . . ,� TAKEN c 1 fir?`+d"i:7 STORING: .)i�',.3.f,i� I x NOT STORE AT TEMPERATURES €ABOVE . O IN `")IRE.t�T SUNLIGHT, DO NOT, i. 1 ,.i p"''..' tom'I"E 1 . a.:'.,. .i--. NOT �.t3 i�EL`„ .4.r..i.21i" .Jim' a. .. CONYAINERZ PUNCTURE (':.: �:L.Tl.ri• c:_�+,C—iRq INCINERATE/; '( 5' �`1 {�!r.'� a,�O 17'aO E t �BR yR..A i'E e:;',/��I�"CA}Y''h.1 MISTS OR SKIN. �'�A}4�ORS. - AVO KEEP PRODUCT OUT{ 00 EYES. r I#�AY_,_:R THAN AIR AND WILL ACCUMULATE A POINTS.t �'S. VENTILATION {'N VAPORS 1�.� I";ftE '�� -I r -•1;Cl.li�sz.�•�_r; i'�_ ;��t I~.at4�! :I!•;` 4 4 I -� l ': -$i:1Ui_I"I i NCL.U'DE -l_(.j:1R i...1:�4'="'. EXHAUSTING! - rfiG:.EP OUT OF THE REACH OF CHILDREN: .yE\..TIO4•y._.X_ ..I.- R IA N S P 40 R T A , :'s.' S N D A T DOT PROPER SHIPPING NAME CONSUMER COMMODITY DOT HAZARD Ct r> > NIA A T V. t1 AA i'2"1" DOT! z...r B E.I_..f 1 i o i sCARD: OWE,, ice'(mil E,, -s� , T [ I INVENTORY}}^-FO1^Rp" •, -ALL ci'�-sGR4-DIi,_.NT',: ARE LISTED EPA� l�u''\,+ft CHEMICAL ��YY� f'' il..11 // {�S /'�C}^ R7 PART S °'S ny\�4..�"IRG IN �A ,`_.,ISiE�7LE i..ONI E`tIi'+t4a..F? ) : N�.a4•E •� . EPA 1-.VN c�: �.\./4 I�i't f�(�6'�C f �. I� -.'�F.1...' ( •`#1 i 'V`sre J TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM 16''c I 'NAME OF FIRM: CHRis �vLLoc-K ��(�s� �.�c MAILING ADDRESS: (p,Zp C ,jANoQC-N 1.o,4D �4YANo41S NSA- TELEPHONE NUMBER: (0(7_ 775- lI30 CONTACT PERSON`(�(oe�►�b A .�,:q�Ian�r �dn+rol�c� aR M •�i�aCl Ste,- ''a` Does your firm store any of the toxic or hazardous mat-er ais-1'i:sted-below, i either for sale or for your own use, in quantities totalling, at y 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: 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 i —�� 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 ^go�- Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCBs Car waxes and polishes Other chlorinated hydro- Asphalt .& roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids- � ® toxic or hazardous (please (dry cleaners) HEALTH DEPT. list.,,;: Other cleaning solvents TOWN OF BARNSTABLE Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners MAY 1. 4 1981 Disinfectants Road Salt (Halite) tY TOWN OF .BARNSTABLE BOA R D 0F. i'H'EALTH r 'zfi{ CONTROL OF .TOXIC AND HAZARDOUS MATERIALS TNSPECTION SHEET S� x � /3 Zia n, "3 ' �1 types of materials 1) /,�5 M6Y'" 2) 4) I11 ; (re 5) O lr D, D@scrlption of material(S) use: I Storage (denote product by` number listed t above)kR {I" � '"` A "C.ontalner'S + '�r metal glass paper plastic cans';bottles,j ars Ta "IN dru_Ms,: 54, b arre`l s t r � S�aF311 t F 5 4� 'S�,''e 4 . ` _ aboveground tanks' : r , t.cl t 41u� tl Tflr-.j�Yki°,Y/a..t• - -. ,6� r underground tanks ,5 do0 e t, bags,bbxeS' rla ar s{w�1� sF} ,t.; sFl a �v �r xY e kr 1A. FIE' s4 open,loose,uncovered14 t x vx�tc{r� �3IJn1 tx� r inadequate labelling O wt 'zuG`r,D � B Stora a Facility x Q, ,�x •�i �§ g Yi✓or.# Remarks/Reconiinendationsf ° 4 1 '1I I t F V 1 1 ," 1 Indoor. ; ,�'t { � ,r TF > 'a) '`separate,:' contained room q ,t{1 G.k } � � b) ,stored;in. .general ,work area .� MU 1) inadequate,ventilation -�'t=. "` ' ' ' ' F! L=� + uI .tl r'�,rt} .. k G s,} r ii) floor drains . :I lii)_ inadequate`,fire protections q: r2 Outdoor ter te' �Ifi{ a) :'uncovered,` exposed to weather r v �-�• , �,,�,��}.,,,�k b) pervious surface/catch basins' ' r>p � 4 �I Disposal ,Rec,lamation/ReC clingp unit` ! 6 B' On=site•disposal _� _ - ��, � ' , ,� �5 ,; , p 1. Town sewer: 'f 2: Regular septic system. {' a 3.' Separate holding tank r' i �C 'Off-site disposal r �Yt ' .1,. :.hauled by''own ,firm `j. 2. hired hauler G O n. x a) name of hauler 4 #' `{ b) address or disposal site aq [ y4TMn; er5.aut(s) Interviewed Inspector ✓ x 'e r yt=t ' f 1 1 kr�i f. Date it .[..q, r.. .., t • ..:: .. r: �.,r r,la t,,.,-' t.-,. . 3 d,.r' TOWN OF BARNSTA13,4&'. .COMPLIANCE: CLASS::,.1 .prine,Gas Stations,-Repair Printers --R ARD OF HEALTH Q�satisfactory 3 Auto Body Shops R 4. Manufacturers ' Ounsatisfactory- " COMPANY j - t ;4'� 1�` (see"Orders") 5. Retail Stores �. 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Undetground Tanks IN OUT IN IOUT IN IOUT # Lyallons AL7erest? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) � d new motor oil (C) transmission/hydraulic Synthetic Organics: , degreaser's �� f' Misce(J,•,�,.aneous: t a z DISPOSAL RECLAMATION REMARKS: + 1. Sanitary Sewage 2. Water Supply OTown Sewer O Public 0 On-site O Ptlivate 3. Indoor Floor Drains: YES - NO y ' 4 Holding tank: MDC O Catch basin/Dry well - ._-- On-sites stem 4. Outdoor Surface drains-YE NO Holding tank: MDC Q,, Catch basin/Dry well _'elf ._...- :i __r�,.-r. �� c ..r _ - �r r r•.' 0 On-site system w S:' Waste Transporter Licensed? Name of HaUlej Destinatinn Aaste Product i J f 12 z3 81 Person(s) Interviewed ,,f !; Inspector Date �i"OWN OF BARNSTAB`L`E COMPLIANCE.: CLASS �i'. 'Iarine,Gas Stations,Repair " Runsatisfactory- 1-7ii. satisfactory . • Printers BOARD OF HEALTH 3. . Auto Body Shops q, Manufacturers 6110' (see"Orders") S. Retail Stores COMPANY.• f u r1' — 6. Fuel Suppliers ADDRESS i � � lea� Class: 7. Miscellaneous r QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors). MAJOR MATERIALS Case lots Drums AboveTanks Undetground Tanks IN UT IN 0 IN OUT Z1 e West? r Fuels: ,,�` 11 1 Gasoline, Jet Fuel (A) V Diesel, Kerosene, #2 (B) / ~ Heavy Oils: waste motor oil (C) new motor oil transmission/hydraulic Synthetic Organics: y ! degreasers I(( Misc l n ous: DISPOSAL RECLAMATION REM . 1. Sanitary Sewage 2. Water Supply - 1 Town Sewer O Public 17 —#' On-site Private 3. Indoor Floor Drains: YES NO Holding tank: MDC _ O Catch basin/Dry well — On-site system 4 Outdoor Surface drainsYE NO ' \ O Holding tank: MDC Catch basin/Dry well OOn-site system _� ---- -------- ----- S. Waste'jiansporter . " Licensed? 'e D' ctination W. P.rodUct ' ei Person s)Ys-It t.drv•�ewed Inspector Date J ,. , TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: �� C� l`. " � Mail To:Board of Health MAILING ADDRESS: WAP If -'�.,Town of Barnstable TELEPHONE NUMBER: 2 '�l r� P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallonsliquid 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: 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 ' Please put a check beside each product that you store: V Antifreeze (for-gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants _ V Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel V"' Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) V Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine V Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes ✓ Paints; Fertilizers (if stored outdoors) V Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels V Metal polishes (including chloroform; formaldehyde, v� Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY vr f � /¢ � (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 10 0,0-_ io t t v k g lass' ?.Miscellaneous 44V.Vl.3Q ANTITIES 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: aso ' 2 (B) Heavy Oils: waste motor oil (C) CpAal new motor oil (C) � transmission/hydraulic Synthetic Organics: dasers ��� sd�it�9 G�t iscellaneous: 8 DISINOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply / QRl O Town Sewer 15�Public 4A, AfrU5 On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well n O On-site system 4. Outdoor Surface drains:YES NO O Holding tank:MDC 10 44—.d e Catch basin/Dry well '�T,(el+?� On-site system 5. Waste Transporter Name of Hauler Destination Waste Product Q YES NO 1. �J 2. �. Person (s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Manne,Gas Stations,Repair BOARD OF HEALTH .O satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6..Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground 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 Orga�zics: degreasers 4n Miscellaneous- AZ IV f4,4 e KA4 / - v ox-Oez DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply - O Town Sewer OPublic O On-site . OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC 15iti '4; O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1. 2. . Cl Person (s) Interviewed Inspector Date TOWN OF RARNSTARLE r COMPLIANCE: CLASS; 1. Marine.Gas Stations.Repalr Q satisfactory 2. Printers tTMR D�• . OF HEALTH 4 �anu actu Shops • Qunsatisfactory- 4.. lanufacturers COMPANY �J` A (see"Orders") 5. FuelRetail Stores �_. _ ,,�1 ,/ '" � 6. Fuel Suppliers ADDRESS �/ /_• ;' t` �'�r J Class:�4 7. Miscellaneous ANTITIES AND STORAGE (IN=indoors; OUTwoutdoor. MAJOR IUIUI R Case-lots Drums AboveTanks' Undetgrohad Tanks IN )l QUT _ITL _ d gallons &m EW Fuels: • Gasoline, Jet Fuel (A) Diesel. Kerosene, 112 (B) Heavy_Oils:7_o:711 ,- waste mooil - (C) Cne�w moto _ (C) - 1 Y transmission/hydraulic Synthetl.c Organics: v degreasers • Miscellanezous- OVICAY P),kA . ,- Ne-M) A Of/rk p 0(_dered 51iv ISPOSAL REC , M T ON REMTRKS: 1. Sanitary Sewage 2. Water Supply Town Sewer O Public I �_Ji !f' � ,_NV 0 W'A r 6� 1,c� -P -A a ; on-site (� J(L- Q Private 3. Indoor Floor Drains: YES NO ,t K�T'� (,4)l I1,_ACYW I A0W)1_l l A,0C-,�1� Q [folding tank: MDC Y{ Catch basin/Dry well � �•-� On-site system 4. Outdoor Surface drains:YES TIC NO Q r/ , �f) QIlolding tank MDC: N t/ Catch basin/Dry wall��}4 t O`On-site system S. Waste Transporter �I�y/ � 5� � `+jl�Ei� � Licensed? �dID�S2f'AaU1��� f J .nest:Lri_on o Wngt Produ= t __ A-r-Fr.e � er e: son s Interviewe -Inspector Date °