HomeMy WebLinkAbout1040 IYANNOUGH ROAD/RTE132 - HAZMAT �-�"
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TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: �/��'�'rs������� Board of Health
MAILING ADDRESS: 0'-7' -3gr 10�e Town of Barnstable
TELEPHONE NUMBER: 7- P.O. Box 534
CONTACT PERSON: xy- 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 qua tities totalling, at any time, more than 5 gallons liquid volume or 25 pounds dry
weight? YES V 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 gallonsliquid
volume or 25 pounds dry weight. Please put a check beside each product that you store:
Antifreeze (for gasoline or coolant systems) Drain cleaners
_/V Automatic transmission fluid Toilet cleaners
_—' Engine and radiator flushes Cesspool cleaners
Hydraulic fluid (including brake fluid) Disinfectants
Motor oils/waste oils V_ Road Salt (Halite)
V" Gasoline, Jet fuel Refrigerants
tl^ Diesel fuel, ke�e, Pesticides (insecticides, herbicides,
V Other petroleum products: grease, lubricants rodenticides)
_ yl*� 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
Car wash detergents Lye or caustic soda
V, 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)
I/ Other cleaning solvents
Bug and tar removers
Household cleansers, oven cleaners
White Copy- Health Department/ Canary Copy-Business
TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
Asatisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY (see"Orders") 5.Retail Stores
! 6.Fuel Suppliers
ADDRESS f Class: 7.Miscellaneous
UANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons 7,77 Test
Fuels: S/
Gasoline,d_et tA7
41
Diesel, Kln �B)
Heavy Oils: U !�
waste motor oil (C)
new motor oil (C)
transmission/hydraulic � ��T t
Synthetic Organics:
degreasers
" G7�'c���y� i>'� I✓
«L, t � ,f
$isc011aneG���,��
f 71 �i
Y1
P1 4 4
71
DISPOSAURECLAMATION /REMARKS:
1. Sanitary Sewage 2.Water Supply dV � sz f
O Town Sewer OPublic " `r'.'
on-site OPrivate
3. Indoor Floor Drains YES-NO
,V'Holding tank: MDC
r✓ �
O Catch basin/Dry well " ✓
O On-site system A
4. Outdoor Surface drains:YES NO ORDER '.
O Holding tank: MDC 14-
O Catch basin/Dry well
O On-site system
5.Waste Tr . sp rter
Name of Hauler Destination Waste Product LicensedT
_ YES NO
1.
2. �
Person (s) Interviewed Inspector Date
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: Board of Health
MAILING ADDRESS: /�I z ��r Town of Barnstable
TELEPHONE NUMBER: P.O. Box 534
f • � Hyannis, MA 02601
CONTACT PERSON: csC�z�f
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in uantities 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: AO
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
V/ Automatic transmission fluid Toilet cleaners
Engine and radiator flushes Cesspool cleaners
Hydraulic fluid (including brake fluid) Disinfectants
Motor oils/waste oils V7 Road Salt (Halite)
Gasoline,, -fie 7 Refrigerants
t/ Diesel fuel, kefe&e4w, # Pesticides (insecticides, herbicides,
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)
Rustproofers Swimming pool chlorine
Car wash detergents Lye or caustic soda
I/ 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
y Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners)
d/ Other cleaning solvents
Bug and tar removers
Household cleansers, oven cleaners
White Copy- Health Department/ Canary Copy-Business
y r
TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
COMPANY ear=ass z j f4 (see"Orders") 5.Retail Stores
C 6.Fuel Suppliers
ADDRESS /� �v Cy.y. �- ".. Class: / 7.Miscellaneous
%�;✓ - 1 �� i''�''� ANTITIES 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, >��rnenno' u� rT2
Heavy Oils: IIVA P
waste motor oil (C)
Y"
new motor oil (C) fd ��
transmission/hydraulic,,_� a
Synthetic Organics:
degreasers
Mis llaneous.
��' •�r�`�- �'� Imo'
� z �
a 'all
DIS OSAL/R.ECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer /Public c y%
O On-site OPrivate e.
3. Indoor Floor Drains YES-NO �I
(Holding tank:MDC l f
or
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YESNO O ERS:
O Holding tank: MDC H A Iry ,tee
O Catch basin/Dry well
O On-site system /��
5.Waste Transporter
Name of Hauler Destination Waste Product
YES INO
2.
Person (s) Interviewed Inspector Date
- TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
a
NAME OF FIRM: EV E R ETT H. CORSON, INC, 01.208
MAILING ADDRES�ROUTE 132 EH-3
YANNIS, MA 0260t C-11572
TELEPHONE NUMBER:
CONTACT PERSON: Cc-,
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 a�n time, moxe
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 stb"red 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 w 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,lubricants Swimming Pool chlorine Degreasers for engines and metal Lye or caustic soda
Jewelry cleaners
Degreasers for driveways & garages Battery acid (electrolyte)
Leather dyes
es
Rustproof ers
Fertilizers (if stored Car wash detergents outdoors) .
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
Floor & Furniture strippers chloroform, formaldehyde,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(dry cleaners ) toxic or hazardous (please
list) :
Other cleaning solvents
Bug and tar removers RECEIVED
Household cleansers, oven cleaners HEALTH .DEPT.
Drain cleaners TOWN OF BARNSTA
Toilet cleaners
Cesspool cleaners
Disinfectants
Road Sal '_ (Halite) MAY i 3 1981
TOWN OF BARNSTABLE j
BOARD OF HEALTH
CONT L OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET
F I R� &-n
ADDRESS :. /3
Major types of materials: 1) 2) 3)
4) V�,GI�cR�- 5) 6)
I. Description of material (s) use: ut�
II. Storage (denote product by numbe listed above)
A. Containers
metal glass paper plastic
cans,bottles,jars 1
drums,barrels Ts'
i s cr/
aboveground tanks 1
underground tanks
bags,boxes
open,loose,uncovered
inadequate labelling
B. Storage Facility ✓or-# Remarks/Recommendations
1. Indoor
- a) separat(3, contained room
b) stored in general work area
i) inadequate ventilation
ii) floor drains'
iii) inadequate fire protection
2. Outdoor
a) uncovered, exposed to weather
b) pervious •surface/catch basins �� f
III. Disposal
A. Reclamation/Recycling unit
B. On-site disposal
1. Town. sewer
2. Regular septic system
3. Separate holding tank
C. Off-site disposal
1, hauled by own firm F
2, hired.hauler C_ 0 A
a) name of hauler
b) address or disposal site-
. �
Person-(s) Interviewed .Inspector
T Date - - - -
COMPLIANCE: CLASS111. Marine,Gas Stations,Repair
TOWN OF BARN STA BL'E 1 i . �
I . . I ,� ,��A L Printers
satisfact ory
BOARD .,OF HEALTH 3 Auto Body Shops
ct 4 Manufacturers
0 unsatisfactory-
Retail Stores
"0 -1)(see"Orders") so
COMPANY /4�c %. � 't
ADDRESS' Wq 0�S ' . 6. Fuel Suppliers
Class: 7. Miscellaneous
QUANTITIES AND'STORAGE (IN=indoc.rs; OUT=outdoors)
MAJOR MATERIALS Case lots Drums - AboveTanks Undetground Tanks
I IN IOUT IN UT IN IOUT I zllons Ave rest?
Fuels:
Gasoline, Jet Fuel (A)
Diesel, Kerosene,, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil
transmission/hydraulic
Synthetic organics: ti
degreasers
Miscellaneous:
DISPOSAL RECLAMATION
REMItRKS-
I, Sanitary Sewage 2, Water Supply
C) Town Sewer -Public
aOn-site 0 Private
3. .Indoor Floor Drains: YE 'No ,
Holding tank: MDCt
O Catch basin/Dry well O'�
URVERS:
On-site System
0
4. Outdoor Surface drains:YES NO
0 Holdin tank:- MDC
0 Catch basin/Dry well
0 On-site system
S. Waste Transporter. Licensed? .
Name of Hauler_ Da!t i nat ion _Wtat a, Product YFS NO
.01 12
C,f ertoft$r�lnterliewed U nspector Date
23
COMPLIANCE: CLASSx 1. Marine,Gas Stations,Repai.r
N OF BARNSTA ISLE: 3 2printers
� � , atisfactory 3. . Auto Body Shops
OA R® r' OF H 4. Manufacturers
unsatisfactory
ee Orderss" S� Retail Stores
COMPANY '� f • s ) 6. Fuel Suppliers
ADDRESS „ " st.� 7. Miscellaneous ,
QUANTITIES AND STORAGE (IN=indocrs; OUT=outdoors)
Case lots Drums AboveTanks Underground Tanks
MAJOR MATERIALS IN 10XIT IN 0U IN IOUT # g2llonse s ?
Fuels:
Gasoline, Jet Fuel (A)
.Diesel, Kerosene, #2 (B)
Heavy Oils;
/waste motor oil (C)
new motor oil. . (C)
transmission/hydraulic
-4elfffSErs
_ r
V�
Miscellaneous:
DISPOSAL RECLAMATION REW.RKS:
1. Sanitary Sewage 2. Water Supply
OTown Sewer O Public -�J oQ
On-site ., a,Private
i
3. .In oor Floor Drains: YES N0
O Holding tank: MDC _
O Catch basin/Dry well On-site system
A. Outdoor Surface drains.-YES NC
Q Holding tank: MDC _
O Catch basin/Dry well
OOn-site system .' ____ _ _• e--
S. Waste Transporter �' Licensed?
Name of-Hauler-
NDPctination
[,zcte Product
f
ss Int. Inspector U to
23 81
'A
�Q�OFTpFTO�o TOWN OF BARNSTABLE
! OFFICE OF
BAaMAA& i NST
BOARD OF HEALTH
y rasa .
vo 1639• 367 MAIN STREET
HYANNIS, MASS. 02601
August 14, 1987
Everett Corson
Corson Cadillac
Route 132
Hyannis , MA 02601
Dear Mr. Corson:
You are reminded that State regulations require periodic
pumping and or cleaning of all MDC traps (Metropolitan
District Commission, . gas and oil separator tanks) ..
You are directed to contract with a licensed hazardous waste
transporter\contractor to perform the required pumping and or
cleaning of your MDC trap by September 11 , 1987 , or provide
proof of such maintenance performed within the past three
months .
You are further directed to have your MDC trap inspected and
cleaned if necessary, by a licensed hazardous waste
contractor every three months . Written proof from a licensed
contractor will be required.
Inspections will follow by the Health Department to verify
compliance . _
You are reminded that failure to comply could result in a
fine of $200 . 00 daily under the Town of Barnstable Toxic and
Hazardous Waste By-law.
Very Truly Yours ,
_Urohn M. Kelly
Director
Barnstable Health Department
{y
r
- � •s.Rp�RW�j7n?w?e�:.'p.axti.r:Pe:..^.r.,.-:rt.,r::.. ..
T- 'p COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r
4V IN CIF• `'BARNSTA BLE
BOARD OF HEALTH satisfactory 2. Printers
3. Auto Body Shops
Q unsatisfactory- 4. Manufacturers
COMPANY �� (see"Orders' ) S. Retail Stores
— 6. Fuel Suppliers.
ADDRESS ) �� )� Class:� 7. Miscellaneous
Y
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors)
MAJOR MATERIALS Case lots Drums AbOveTanks Undetgrouad Tanks
IN IDUT I # e
Fuels:
. Gasoline, et Fuel (A) � �����
Diesel, Kerosene, #2 (B)
Heavy Oils:
• �ste �motoroi (C)
or of (C) .Cx,�
transmission/hydraulic
Synthetic Organics:
degreasers
M Miscellaneous:
DISPOSAL RECLAMATION REMARKS:
1. Sanitary Sewage 2. Water Supply
(Z Town SewerPublic OX
On-site 10 Private
.3. Indoor Floor Drains: YESLl. NO -
4 Holding tank: MDC XIF '
O Catch basin/Dry well
0 On-site system
4. Outdoor Surface drains;YES NO
Q Holding tank: .MDC
O Catch basin/Dry well
OOn-site system
' S. Waste Transporter Licensed?
Namg of HaUl [ es in ion ,1jaste Product YFS1 NO
1
Q �_........
Nco(AVA -InNNO /AA1(7
12 23 81 Pe son Interviewe Ins c or D t
MEMBER
-Z . 345 WEST MAIN STREET `� INVOICE
���® INC NORTHBORO, MASSACHUSETTS 01532 ETEL: (617) 393 2537. geus®unee�rMs A SERVICE CHARGE OF 1'/z
INTEREST PER MONTH (18%
PER YEAR WILL BE CHARGED
ON OVERDUE BALANCES.
S S
0 H
L EVERETT H. COR'=:i tN I ;SAME
D 1040 I YANNO►It tH RD. P
T ROUTE 132 T
0 HYANN I S, MA c._)t!,C)1 0 C)C)C)C)r)
r.. ::- ._tz g"' A _Y '�7-x�. �..t.<SHIPPED Y COMP,IETED ,TEFiMScc a,; 1NVQICE ND.
DATE 7_,s YOUR.ORDER NO SNIP UTA,._ * RS
)9/15/87 CUST# )14482 ?/-`/87 NET 2475
>:QUANTITY.x^t ` DESCRIPTIONS _. sH K r ".UNIT PRICE .,, f i- AMOUNT
F'L!MP AND CLEAN h11;C TRAP
. C)C)t TYVEF.-:: SUITS 10. C)C)( 20.00
5. r)C)k: 17H DRUMS 24. 00c
12C),IiC)
14C). (__)04. ti�r,")I HR'=. POWER TA I LG sTE°gTRUC_!�•lm E _,�),0 C 120.C_)i)
4. 00)f it
HRS. VACUUM TRAILED}2 45. 00C 18C), CsC)
5.00i DRUM,3- LC I,S'P0c"AL 134. 00 6-70. 00
5 ), C)Ot GALLONS INS MASSTRAM iF CIRTEF-�FEE� -��� Ki �)
1 . C)!�< MA TRANSPORTER PORTEF F'EE 1 i'�y�SLL� , r.u) , �� 1:�, ;�i)�: 1' . ::"0
cO. 00 GALLON:—::,* t x x� � �''_
L I_F+ ) 'AL ). L. _t 1 t)C;
I . t_0 t=:L r"-�I i=;HELL = fi g t ` �_ sk - y� '�6 [)a 0 )(
16. OC)I HR_'. LABOR t 26.
r :: w
P .
5-, {)(r;�r ALE' T Y 7. C)C)
tL IKIT`" DUE
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k s` ri v o r s a�
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-SERVING-THE PETROLEUM INDUSTRY s EQUIPMENT SALES,`SERVICE, INSTALLRTIONS f
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