Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0657 YARMOUTH ROAD - HAZMAT
�61 Ya(M A) a 4lrof)►s A r • � Number Fee 1225 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Premium Auto Body 657 Yarmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons 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 i Town of Barnstable Inspectional Services BARNSTABLE:1. 0(.TNE T[L_ n�nne.me.=_.r..;re_vil=-con{*.arnnsr . �. Public Health Division e-xmn • » B MASSSB , f Thomas McKean, Director 1�a A i639. o`�� 200 Main Street Hyannis,MA 02601 rEo nu►+ � Y � -K Office: 508-862-4644 Fax: 508-790-6364y 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 ❑ *A late charlze of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL N 3�Jr��r 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. ;7 - 4. FULL NAME OF APPLICANT: J 7 en jj ,i yj—) 5. NAME OF ESTABLISHMENT: e 6. ADDRESS OF ESTABLISHMENT: ya)roo:ri 1+ T Vn n f_S 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: -50 ZS K 1 5 9 2 2_ Z 9. EMAIL ADDRESS: 10. SOLEOWNER: -� ES 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#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE V,�,; 4 - 1 Q:\Application Forms\Haz Mat App Revised 09-1 docx .01 P`°FTME i°yam Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSPABLE. MASS. g, 200 Main Street• Hyannis, MA 02601 q s639.1, rEDMn+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C Ot I-XIS k-P-,5 orl Date: z / Location/Mailing Address: a S+ 4A A t 5 Contact Name/Phone: a �c� - 8— Inventory Total Amount: d SDS: d�5 License#: Tier II : M 0 Labeling: 19 Spill Plan: Oil/WaterSeparator: _ Floor Drains: "Ie'5-MvI4 Emergency Numbers: -' Storage Areas/Tanks: VV0l tL-tNv,%(,&t6 -5WJkCLA4 Emergency/Containment Equipment: q,I t 0&II&ay 1w pco e�,.,c -5tvr� wkc� Waste Generator ID: &I� .At Was et Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: k45 ZA,(S 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. VZ.A-44-6012 f-c $o th Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers-+L Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Jv4vw4 `{ J``�L�` Motor oils _�_ Miscellaneous Corrosives 1, k Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil ZZ Disinfectants Z, Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages I Pesticides: Caulk/Grout insecticides herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar / t�1 Swimming pool chlorine Kp 1 (��4 Paints, varnishes, stains, dyes/�i � g Lye or caustic soda Lacquer thinners < Ot V Miscellaneous Combustible 7+1 Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons ti Laundry soil &stain removers (including carbon tetrachloride) h vyincluding bleach 1 Any other products with "poison labels" ,vm-tp,So t w 7-o 01\4 (including chloroform, formaldehyde, `a CO. k%&% ki1KG 44-4k� ovo 110 hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: •e. v K k 02,2 ir<e at < Inspector: ►'mil�� Sa-I-� • I k�l o+ti vo ( , Imo.I- GIB,I ar,� 1 � I � r4K V I e� v�ex,pol{ .5 g eV • Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS `°F�►�►oy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABNA�BLE.$! 200 Main Street• Hyannis, MA 02601 ,61A a,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MA'S ,J Business Name: �C'2.�"t i UVV, A U+-D 65� Date: 7 3 Location/Mailing Address: AS-7 Contact Name/Phone: 1?2,22- Inventory Total Amount: '� D a-t SDS: -'d o 10�a�v�. License#: I'LZ S -� Tier II : 00 Labelina: I Au Spill Plan: 2-vKk•K-- v Oil/WaterSeparator: Floor Drains: Emergency Numbers: 0k-<— Storage Areas/Tanks: -t vS -e- X Emergency/Containment Equipment: , 61!!� ,k,e Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: nnn erg 1a t.�Iol/k•>'.�e, Nv•vkC. es4ar"k, � L�G(e LIST OF TOXIC AND HAZARDOUS MATERIALS � � L� tom. �,tive�nke•r Yvtti,te-�,w.l• NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous m4rial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. �L 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 II`l 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" oer<XX nya� U). ,1J (including chloroform, formaldehyde, IMaS g t�erOTG c 11 ,•�Q.cMoJT4� hydrochloric acid, other acids) c0WC,0 - . Yar, &C VIOLATIONS: ORDERS: I NFORMATION/RE OMMENDATIONS: )vA- e •-, Q c,k A- w<-,C C D `2 vwOV11- vL ykX-}-WLr7v\ ,• ` I Ins ector: I v La%J � ova-v� '�,Ll G `k- `{� ex��vqu,5 M�6. ✓ y �� IAA--� P ri�O v>+�, � -e-xF cility Representative: t �v�ti U*AA a�9J,� �eN2ly.off(�l i�'�. N.� ��I l '�4 `''P WHITE COPY-HEALTH DEPARTMENT/C\ANARY COPY- BUSINESS �tv-Zq (,OV%r&XWS 0,AyQ1," VQ IRE rogti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. MKS MASS. p` 200 Main Street• Hyannis, MA 02601 9 O i639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD Py Business Name: `&1M/ u+0 It o Date: Location/Mailing Address: ,-Mo 4447 S Contact Name/Phone: e X c 0 , o Inventory Total Amount: v 45--5-o MSDS: ovw License#: D Tier II : Labelina: a64 Spill Plan: o o Oil/WaterSeparator: JJA Floor Drains: 06 Emergency Numbers: Storage Areas/Tanks: �Okk+c&k to a--xS\ 4--C-4^VtN6Ve 5kac c coa.nl- Emer enc /Containme t E ui ment: 4; -� Waste Generator ID: N a o u,q i 4+, Waste Product: Date&Amount of Last Shipment/Freq ncy: v 106 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 I Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants I Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 1 Refrigerants ,L Degreasers for engines&garages Pesticides: ,5 Caulk/Groutlfflee y+3 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 S� Swimming pool chlorine Paints, varnishes, stains, dyes S�°St�, Lye or caustic soda Lacquer thinners s*" y'y�kg��,� —�tZ Miscellaneous Combustible J k 2 3 Paint&varnish removers, deglossers Leather dyes 1 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) I OLATIONS: 0 DM WA 0&4 -�� 4-e �-• ' 1(>%A vl 0VWVkIVtW,5 �Ik-j 12 S DA, , e„ ceAIs ac s a ORDERS: INFORMATION/RECOMMENDATIONS: inspector: w& Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS eu JY • • WH - • • • • • I co Certified Mail Fee Q' $ Extra Services&Fees(checkbox,add tee as eppropdate) 1p� /1 ❑Return Receipt(hardcopy) $ M A C3 ❑Return Receipt(electronic) $ ��� POstm AT ❑Certified Mail Restricted Delivery Here ,a O ❑Adult Signature Required []Adult Signature Restricted Delivery$ p Postage f� m $ r r%- Total Postage and Fees $ p y Sent To UJII . 41eit A Ci O / ................... ---------•--•-----------. ----tan --- ---- Box ----- O Stre tan t.N'-'or PC)t3oz Flo. O Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail labeq. for an electronic return receipt,see a retal ■Aunique identifier for your mailpiece. associate for assistance.V'receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides ; for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Maif®,First-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavaflable for purchase by name,or to the addressee's authorized agent. with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is L insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee;and with,a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipients signature). , of this label,affix it to the mailpiece,apply You can request a haMcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version:For a hardcopy return receipt, complete PS form 3811,Domestic Return , Receipt;attach PS Form 3811 to your mailpiece; IMPORPANE Save U t9 receipt for your records. Ps Form 38005 April 2015(Reverse)PSN 7530-02-000.9047 TOWN OF BARNSTABLE BAR-W r.,,l10 Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager 14 7Y, Address of Offender MV/MB Reg.# Village/State/Zip}/) +,� /' Business Name �l " V am/pm, on 20_ Business Address �>5`7 / f r-i ki v4A 4d Signature of" Enforcing Officer Village/State/Zip ` 14i'� )> > ; ^0 it �G-� c ' r Location of Offense P�evy( IU4� y v v x z ��y / Enforcing Dept/Division Offense � v�� �fa �� ,pit, �r�i('1611✓s ►' �I .t�r(,�A I , ���-c'w 3-t lit Facts �hJ -�` , � r '��1 -�ICI -C 08 This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. ,TOWN OF BARNSTABLE BAR-W 1 1 1 0 Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager 4 x, Address of Offender MV/MB Reg.# Village/State/Zip f. 4 � i _ , Business Name t Y a ?`�._�� `" "' # :/ am/pm, on !r" 20 t' Business Address Signature of Enforcing Officer Village/State/Zip ` Location of Offense �� � ��'s �ti tits , '�.� � � ' �}i Enforcing Dept/Division Offense �'r + u+� t €� E'►t. !t s ti � . ► -. r w , Facts � -� I, a � � �� � i^4.. � F• " f' . 1b i� .. 6•d� ! f,rl "�(j`Y� / G' • r This will serve only as a warning. At this time no legal action ,has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts 'to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. !t Town of Barnstable O�IKE r, Regulatory Services Richard V. Scali,Director Public Health Division BARNSTABLE, Thomas McKean,Director 9� 1639 ; `�� 200 Main Street, Hyannis,MA 02601 Arlo Phone: 508-862-4644 Email: health@town.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 CERTIFIED MAIL 47015 1730 0001 4987 6063 April 27, 2016 Mr. Alex Maccagio RE: Hazardous Materials Inspection- Premium Auto Body Corrective Action Orders 657 Yarmouth Rd Hyannis, MA 02601 Dear Mr. Maccagio: This letter contains information from the hazardous materials inspection conducted at Premium Auto Body on April 13, 2016 that will help you become and remain compliant with the Town of Barnstable Ordinance, Chapter 108,Hazardous Materials. This information is intended to educate you, a business owner/operator in the Town of Barnstable, in order to keep your business operations in compliance with local, state and federal toxic and hazardous materials laws so that you can avoid future regulatory problems. Complying with the Town Hazardous Materials Ordinance can prevent contamination of Barnstable's existing and future drinking water supply, prevent environmental contamination which can bankrupt site owners, lower or destroy land values, drive out residents and industry, depress local economies and endanger public health. Please note the problems and the related orders or recommendations identified at your place of business during the hazardous materials inspection: PROBLEM: • The business does not have a compliant paint booth or filtered ventilation. ORDER: • Federal and state regulations have specific requirements for spray coating operations. See the attached documentation and contact the Massachusetts Office of Technical Assistance and Technology for assistance in developing a compliant spray coating operation. Mass DEP has been notified of the lack of a compliant paint booth at this business. PROBLEM: • Open containers of hazardous materials/waste were observed inside and outside of the building. ORDER: 1 1. • All hazardous materials need to be moved inside immediately. All containers must be labeled and capped or covered when not in use. PROBLEM: • Storage and use of over 25 gallons of hazardous materials without a valid license. ORDER: • An application for the hazardous materials license is included with this letter. You must apply for a license within 7 days of receipt of this letter. PROBLEM: • This business is a generator of hazardous waste but is not registered with Mass DEP. ORDER: • A Generator Registration form is included with this letter for your use. You must complete this form and file it with Mass DEP. Waste containers are to be labeled with the words"Hazardous Waste",the type of waste and the associated hazard (i.e., ignitable, toxic, corrosive, reactive). PROBLEM: • A requirement of obtaining a hazardous materials license is to post an emergency spill plan and phone numbers. ORDER: • Templates that can be used to fulfill this requirement are included with this letter, as well . as a generic spill plan that can be used as a reference to complete the template. Submit a copy of the spill plan with the license application for approval, and post the original at the business. RECOMMENDATIONS: • Information about Cape Cod Extension's Hazardous Waste Collections for small businesses has also been included with this letter for your use. • Continue with cleanup operations on the outside of the building to improve the image of your business. "Good housekeeping"goes a long way in promoting a much better image to potential customers. A follow-up visit will be scheduled in approximately 4 weeks to check on the progress of your facility's compliance with the Town Hazardous Materials Ordinance. If you have any questions about these observations or you need further information, guidance or assistance, please do not hesitate to contact Timothy Lavelle of the Public Health Division at 508- 862-4645. Sincerely, T omas A. McKean, RS, CHO Public Health Division, Director t All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials shall be completed upon receipt of this letter. 2 °p THE fok4 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BnRMA�BLE.g• 200 Main Street• Hyannis, MA 02601 A •6M N. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT QED MPS Business Name: �ew1�Jwt., �., o ao Date: Location/Mailin Address 65� <J�lo 2nri s Contact Name/Phone: Alex Mlzc", 5-02�-2 i 722 7- Inventory Total Amount: ^'3T MSDS: Na License#: Tier II : o Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment E ui ment: {� Waste Generator ID: Waste Product: 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 If,J(V S 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, dyes2S Lye or caustic soda �L Lacquer thinners 15� 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: 6Vtl -Caw,? Gw w w C1 2Q 100.L�2 a� g L� t <k5KAP r7 t ORDERS: � o - •�+� k �k o� INFORMATION/R CO ME DATIONS: Inspector: ` L4041& Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS i �ppIKE7°�yti Town of Barnstable �! Office:508-862-4644 Public Health DivisionFax:508-790-6304 ' BARNSTABLE. ' MASS. 200 Main Street• Hyannis, MA 02601 �prFoMA� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ` (O-OA N owt. A�OA v a t Date: Location/MailingA 6 <�©u 4,Ar �e Address. �'1 �9 �.� , �y S Contact Name/Phone: Alex Inventory Total Amount: 35' MSDS: /)D License#: Tier II :_ A)ID Labeling: Spill Plan: 1 ; Oil/WaterSeparator: N/A Floor Drains: Emergency Numbers: Storage Areas/Tanks: = ` Emergency/Containment Equipment: ✓ � ��i/r Waste Generator ID: �'i�li 5`#'t ���5� Waste Product: Date&Amount of Last Shipment/FrequencX: t " 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 r` Degreasers for.engines&garages y' ,Pesticides: J Caulk/Grout/C,a��f" 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 "f Swimming pool chlorine Paints, varnish 2es,stains, dyes a _• Lye or caustic soda r Lacquer thinners � � � •• ;"� Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes ' Miscellaneous Flammable Is - Fertilizers Floor&furniture strippers' �'' , PCB's Metal polishes $ x ! 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: viri, -C� c `� �� /a�tr 0K Imo,{C C tt �%,itp Ana,' �p' J�t"� b ' ��>, •;"� ` s''.�.�1� r�F �r�� �r���'�uv a.'}k� i R i.a S ����r'� r�art�� h( -i. ca rfl'CJ✓tti.� ,= � P���i k, j����� d � ORDERS: A,,P �� i('n -A, 4 i•k 1•\-o ,,q1A V1 c , t(7 po , ,"'3 ••A D "III, V,1 c,-k C,V--1 INFORMATION/RECOMMEN'DATIONS: ` e Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FINE*o Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMAN Le.g 200 Main Street• Hyannis, MA 02601 Fo + TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ��`� `^'� ��}o lib Date: Location/Mailing Address: 5 Contact Name/Phone: \2 ac- o o t 2'L Inventoty Total mount: 4 m qa,\ MSDS:Pb — W,\�b\,4et%w License#: Tier II : Q o JLabeling:w, ,F3gill Plan: Pt Oil/WaterSeparator: Floor Drains: , o Emergency Numbers: Storage Areas/Tanks: w Emer enc /Containmen E ui m nt: o A RL, Waste Generator ID: — 1 ,,�,\ CS Waste Product: 0 -VA\Kvar %vcN— Date&Amount of Last Ship ment/Freque cy: 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&gar�a9es Pesticides: Caulk/Grout r 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 Z� Lye or caustic soda Lacquer thinners i� 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: \ w \ b , Inspector: Z Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS L `I' it Date: 3 /Za/13 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: •,'a O BUSINESS LOCATION: INVENTORY MAILING ADDRESS: �.�� ya,� ®� 1 iNn�,s TOTAL AMOUNT- TELEPHONE NUMBER: L S—-7-7 5 mo-L L 1 i 1 0 CONTACT PERSON: M K ej &,, v Ala EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: &4Al a INFORMATION / RECOMMENDATI NS: Fire District: N 1S Waste Transportation: 414 � 9444 VlOeS Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No 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, LLacc r thinne��USED (including carbon tetrachloride) oe W NEW 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 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 Applicant's Signature Staff's Initials r i Hazardous Materials Inspection Notes The annual inspection of the above facility was conducted on 3/28/13. The facility consists of two two-bay garages with attached storage space. Premium Auto Body leases one garage from Brito's. Premium does body part painting only. Brito's garage is currently is being used for personal use only. The types of hazardous materials being stored have not changed since the last inspection. The materials included paints, lacquer thinners, paint removers, rustproofers, and miscellaneous flammables, which are kept in a metal cabinet in Premium's leased garage. No waste is produced or stored in Premium's garage. There is one drum containing approximately 20 gallons of waste thinner solvent left by a previous tenant in Brito's garage. The total quantity of hazardous materials in the entire facility was estimated to be less than 111 gallons. Based on this Hazardous Materials inspection,the facility is not subject to the Town of Barnstable's Hazardous Materials licensing requirement. However, regardless of the amount of materials, all businesses are subject to certain safety, storage, and disposal requirements. CORRECTIVE ACTIONS TO BE TAKEN: Material Safety Data Sheets (MSDSs) for hazardous materials used at the facility were not available. Pursuant to the Town Code and federal law, MSDSs must be on-site and readily accessible to employees. There were no records, in the form of manifest sheets, for the off-site shipment of hazardous waste. Mr. Brito said business has been so slow that no waste has been shipped off-site in the past 5 years. He said that the waste thinner stored in Brito's garage would be removed by the previous tenant, who has a Hazardous Waste Identification Number and therefore can transport the waste for disposal. Prior to removal, the waste container needs to be labeled with the words "Hazardous Waste" and "Flammable". Behind the garages, there were various junk piles that included empty drums, buckets, and containers. These should be cleaned up or at least organized and labeled as empty. Per a previous inspection request, a new concrete containment area has been built for the above-ground heating oil storage tank. Town of Barnstable O�THE Tpw Regulatory Services y '1� Thomas F. Geiler,Director Public Health Division * BnxtasTns Thomas McKean,Director 9 MASS' � 200 Main Street, Hyannis,MA 02601 s639. iOrFC�.l A Phone: 508-862-4644 Email: healthgtown.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 March 28,2013 Mr. Manuel Brito RE: Hazardous Materials Inspection Premium Auto Body/Brito's Auto Body 657 Yarmouth Road Hyannis,MA The annual inspection of the above facility was conducted on 3/28/13. Based on this Hazardous Materials inspection,the facility is not subject to the Town of Barnstable's Hazardous Materials licensing requirement. However,regardless of the amount of materials,all businesses are subject to certain safety, storage,and disposal requirements. CORRECTIVE ACTIONS TO BE TAKEN: Material Safety Data Sheets(MSDSs)for hazardous materials used at the facility were not available. Pursuant to the Town Code and federal law,MSDSs must be on-site and readily accessible to employees. These can be obtained from the supplier of the materials. An MSDS information sheet has been included with this letter. There were no records, in the form of manifest sheets, for the off-site shipment of hazardous waste. Mr. Brito said business has been so slow that no waste has been shipped off-site in the past 5 years. He said that the waste thinner stored in Brito's garage would be removed by the previous tenant,who has a Hazardous Waste Identification Number and therefore can transport the waste for disposal. Prior to removal,the waste container needs to be labeled with the words"Hazardous Waste"and"Flammable". Behind the garages,there were various junk piles that included empty drums,buckets,and containers. These should be cleaned up or at least organized and labeled as empty. Per a previous inspection request,a new concrete containment area has been built for the above-ground heating oil storage tank. The Barnstable Public Health Division appreciates your cooperation and acknowledges your intent to maintain compliance with the Hazardous Materials Ordinance. Please contact me at the above telephone number should you have any questions or comments regarding the Inspection of your site. Very truly yours, Timothy J.Lavelle Hazardous Materials Specialist YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: �p ZO s� Fill in please: APPLICANT'S YOUR NAME/S: M,4CF-t-41.- �° BUSINESS YOUR HOME ADDRESS: AAA- 02001 TELEPHONE # Home Telephone NumberL`3 e` NAME OF CORPORATION: -r- (U M NAME OF NEW BUSINESS &0 TYPE OF BUSINESS CCy IS THIS A HOME OCCUPATION? YES ADDRESS OF BUSINESS 65-7 MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S F CE This individual has be r d of a y ermit requirements that pertain to this type of business. A orized Signature* COMMENTS: ,�� — 2. BOARD OF HEALTH This individual h b for e d er squire is that pertain to this e of business. Mir WIVIK wI1H ALL Authorized SigKature** .HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE Dater I / P-©1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: i1uvyj 14(i co &cjv BUSINESS LOCATION: M-✓"u oni� INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: �p EMERGENCY CONTACT TELEPHONE NUM ER: MSDS ON SITE? TYPE OF BUSINESS: ,Ad obta 14 INFORMATION / RECOMMENDATIO S: Fire District: Waste Transportation: No ,,4fie, di�� Last shipment of hazardous waste: S Ups Name of Hauler: I Destination: Waste Product: W'Ccsj-�e- Afl✓ine- ' ' Licensed? Yes .No 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 re uires 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 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 I CANARY COPY-BUSINESS P s Signature Staff's Initials `ppTNETp�� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BABNASSBLE.g` 200 Main Street• Hyannis, MA 02601 s639. MA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD 'S Business Name: �r' o S TP��v sa.�e SOq Date: 4� 3 Location/Mailing Address: '� Contact Name/Phone: '7-7N-`�9`f-33` 6 Inventory Total Amount: 4 25 y0 SDS: V�&" License#: N Tier II Id Labeling: Spill Plan: " Oil/WaterSeparator: tilA Floor Drains: IJb Emergency Numbers: D-K Storage Areas/Tanks: I Emergency/Containment Equipment:_s�LI w .•k� Waste Generator ID: � Waste Product: o.\ Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: 0 . 1 ,Wr &.c.V- k, Q&k 6A 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. J 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+ok%k-e., 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 1(%Il erc 5 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: o ti v14CCV C.0 �- a le-' INFORMATION/DECO MENDA IONS: CAAJ- JI Inspector:---!,' LwyO\Q--,, Facility Representative: resentative: r WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS IKE*oyti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASMBLE.$• 200 Main Street• Hyannis, MA 02601 16,39. �prEO MP�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT12,a/!d /� 1 Business Name: 1px<lro S AA05,des Date: Aytihx- Location/Mailing Address: (65-1 Vto r Contact Name/Phone: Inventory Total Amount: <25' a( MSDS: 0l't `u License#: NIA Tier II : Labeling: IW-G Spill Plan: Al ' faC{o�IG�— Oil/Water Separa or: JJA Floor Drains: Emergency Numbers: Storage Areas/Tanks: I�r �,. 1 1 �v�6, 6- l tip, I -- 0 11e-C E&ov� Emergency/Containment Equip ent: e_ .lvWJ Waste Generator ID: Waste Product: Date&Amount of Last ipment/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 I 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 2.1-l, 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, nn hydrochloric acid, other acids) VIOLATIONS: Cep ka,��r k o\ vV e c 6 .e 19 AP0 Ll,( O S: INFORMA ON/RECOMMENDATIONS: S-L <. %w In �U Inspector. L-0,;4�\ / Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS r IKWE•oy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BAaMAT,S. .�` 200 Main Street• Hyannis, MA 02601 1639.i°'FOHa+8. �0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: J � o rS o Date: i 7- t 8 l y Location/Mailing Address: 65 a-(•mop R Y4Nh, S Contact Name/Phone: Ste, -7?5-- Z,D2�}- aK✓mil 6r,+C> Inventory Total A ount: \1 a MSDS: License#: IJIA Tier II : o _ Labeling: -V- Spill Plan:A1!16 Oil/WaterSeparator: V Floor Drains: K1 Emergency Numbers: If I StorageAreas/Tanks: C a,,.n.��S` 6 � 0�6 Awdt Emergency/Containment Equipment: ova Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Vf, S �2 `�►�v�Kc�C c, A6coLcel 6A G-e-yo- ow oh,e-2 — M"�S�r�-`�D 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 en Ines&garages Pesticides: Caulk/Grout bi `��.11e c��e5�w6� insecticides, herbicides, rodenticides Battery acid�(electrdlyte)/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, �p a� hydrochloric acid, other acids) Q`yam�J-VIOLATIONS: I/�N ha< 5k0-(L == VA --A- 0-owk-4" L-cs 3 < .� b M �� .S "I 11�� �IG �' •S R.1 tok-,&C l 1. %)%A 1�1 1K- d a 1w.tiaie.. RDE olti. Iv 1D� 5 dK INFORMATION RECOMMENDATIONS: 6 plkib&- I ,M.aK.6�0 06z- O o a I"k,-5 W k f-C ot A S -e e o fde, O ,�}•�s� Qa5U l— G�a��-i �,��,�.1►-Ey tA)W:P--10 ��(�-1- Inspector: "vvt-4L'- VoA1,-,kC0 Facility Representative: 70 I � - WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. =it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 15` FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. Fill in please: DATE S APPLICANT'S YOUR NAME/CORPORATE NAME j2t�rhy �� j�(\�J�S pru�j C-f,Vr BUSINESS TYPE: \J S'e,j �(,� SGi R5 BUSINESS YOUR HOME ADDRESS: (boo tiJ 0:7 X E b`r.,,-ni5 >M TELEPHONE # Home Telephone Number NAME OF NEW BUSINESS_ _fc>` �v�p S��S Have you been given appr oval from the building division? YES NO ADDRESS OF BUSINESS - ( 'Ps) MAP/PARCEL NUMBER .? When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate.your business, in this town. 1. BUILDING COMMISSIONER'S Of FICE This individual has be fif, med any permit requirements that pertain to this type of business. Authorized Signature' COMMENTS: 2. BOARD OF HEALTH This individual ha be informed of the permit requirements that pertain to this type of business. t •rowV 111 MUST COMPLY WITH ALL Authorized Signatures`` HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSUMER AFFAIR (LICENSING AUTHORITY) This individual h inf rmed of the licensing requirements that pertain to this type of business. Rthi gn ture 'COMMENTS � F a TOWN OF BARNSTABLE Date: Z.I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: i �S A-v D —scl- les BUSINESS LOCATION: ES? kci(MOU�k OCil hY9A/11S, /'I/� INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 77L(— CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: USe GCk� INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No 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 As halt&roofing tar PCB's .z Pain , varnishes, stains, dyes Other chlorinated hydrocarbons, �Z 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 Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) (-jA Other cleaning solvents Bug and tar removers Windshield wash l WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials r Town of Barnstable DIKE r Regulatory Services �'1% Thomas F. Geiler,Director Public Health Division snxtvsras Thomas McKean,Director .2 i6 S. 200 Main Street, Hyannis,MA 02601 Ar�D A Phone: 508-862-4644 Email: healthgtown.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 March 28,2013 Mr. Manuel Brito RE: Hazardous Materials Inspection Premium Auto Body/Brito's Auto Body 657 Yarmouth Road Hyannis,MA The annual inspection of the above facility was conducted on 3/28/13. Based on this Hazardous Materials inspection,the facility is not subject to the Town of Barnstable's Hazardous Materials licensing requirement. However,regardless of the amount of materials,all businesses are subject to certain safety, storage,and disposal requirements. CORRECTIVE ACTIONS TO BE TAKEN: Material Safety Data Sheets(MSDSs)for hazardous materials used at the facility were not available. Pursuant to the Town Code and federal law,MSDSs must be on-site and readily accessible to employees. These can be obtained from the supplier of the materials. An MSDS information sheet has been included with this letter. There were no records, in the form of manifest sheets,for the off-site shipment of hazardous waste. Mr. Brito said business has been so slow that no waste has been shipped off-site in the past 5 years. He said that the waste thinner stored in Brito's garage would be removed by the previous tenant,who has a Hazardous Waste Identification Number and therefore can transport the waste for disposal. Prior to removal,the waste container needs to be labeled with the words"Hazardous Waste"and"Flammable". Behind the garages,there were various junk piles that included empty drums,buckets,and containers. These should be cleaned up or at least organized and labeled as empty. Per a previous inspection request,a new concrete containment area has been built for the above-ground heating oil storage tank. The Barnstable Public Health Division appreciates your cooperation and acknowledges your intent to maintain compliance with the Hazardous Materials Ordinance. Please contact me at the above telephone number should you have any questions or comments regarding the Inspection of your site. Very truly you Timothy J. a e e Hazardous Materials Specialist Message Page 1 of 1 Lavelle, Timothy From: Wadlington, Ellen Sent: Monday, June 01, 2015 10:21 AM To: McKean, Thomas Cc: Heath DeptMailbox Subject: Manual J. Brito, Sr., 672 Yarmouth Road, Hyannis Any information on the above person or property will be sent to Beverly Brito who is named by the Town as the POA for this property. Until that is changed, not sure how you go about it. I put the letter in the file, but saw no. other correspondence in the file or could not access any through a search of the"Q" drive. She has requested any information on this property be sent to his sons with the addresses listed on the letter in the above file. E!!en J. Wadf ngton 6/2/2015 Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Brito's Auto Body Fax: Corp Name: Mailing Address Location: 657 B Yarmouth Road,Hyannis Street: 657E Yarmouth Road mappar: 345-004-000-000 City: Hyannis Contact: :Manuel Brito,Owner State: Ma Telephone: (508)775-2024 Zip: 02601 Emergency: Person Interviewed: Business Contact Letter Date: 4/29/2004 Category: 'VehicleMaintenance Inventory Site Visit Date: 5/3/2004 Type: Follow Up/Inspection Date: public water ❑ indoor floor drains ❑ outdoor surface drains license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- - ❑d on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: .... . . . .....___.._..._... Remarks: No spray booth,Paints stored in metal cabinet.No auto mpH Ce: repair. Orders: Label&date waste drums,Remove batteries&scrap metal&tires,Replace heating oil tank,Call Haz.Waste Co.for ` collection. REMARKS:2/18/98 Paints in Metal cabinet. No MSDS's or Manifests. Tires outback have rims. ORDERS: Obtain Material SafetyData Sheets for all products.Provide last Manifest from Safety Kleen. . Dispose of metal pile and tires w/o rims. tom- 5� DOW Co. Ce 'L��/ r'. Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑d gty's 111 gals or more description: qty.;' unit+of measure i k se ��"�It . waste lacquer thinner 5 gallons acquer thinners 10gallons varnish removers,deglossers 4 cases _.........__............._.__...._._._._........_—_._......._._.....___...._........__.._.__........._......_.........__._..._.__....__..._.__...._...........,....._. ....___._.. __.... _..._._._.___............ waste lacquer thinner ? 3drums Waste Transporter: Safety Kleen Fire District: AA Last HW Shipment Date: Waste Hauler Licensed: Yes rf Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: 's Location: (, T 7 k& Date: S- Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): 2. Waste storage areas: C / ✓ II 3. Satellite accumulation points throughout: 4. HazMat stored outdoors — CHECK OUTSIDE: 5. Shipping and receiving areas: /U,/A 6. Run down of shop activities: 7. Housekeeping practices: HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: rc -� Location: 5 r7 (A v 13 e� Site visit date: C y • Hazardous Waste Manifests: 4,� • Employee training documentation (if required): /V 14 • Hazardous substance spill control and contingency plan: os `/• MSDS on site? /V C> -- • HazMat Inventory records (if applicable): 10 • HazMat Waste Shipping documentation: vl1/s� r� • Spill records (if applicable): /li�" ®p� Date: S_3 -0 y TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: 9 S BUSINESS LOCATION: `` 's MAILING ADDRESS: INVENTORY TELEPHONE NUMBER: 7 d S •--7'"7 5—- Zo z`j • TOTAL AMOUNT: CONTACT PERSON: czuraae, EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOFBUSINESS: a sex-fea-- F1i�E D(STRIGT" OTHER INFORMATION: P,go, a-Na -cam, 01SO S s h-"*S �" s •� M SL�S o� �rf�' 5�r�/ QO�D�[Y1Jb��' lTy1 5 a'��. '��l-a'►r�a�PY1��yE /�p — �Q���o Waste Transportafi�in: A s a-"�;.� t���'n�• �'�' Name of Hauler: Pam. Destination: Waste Product: LAJa z) e. g- � 4,w e Licensed?. a No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze.(for gasoline or coolant systems) Drain cleaners .NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants ,Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil " NEW USED Degreasers for engines and metal Printing iink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, IS NEW 5� ar.�USED - - (inc, carbon tetrachloride)- Paint &varnish removers, deglossers An other products with " Paint brush cleaners Y P poison labels Floor tfurniture strippers (including chloroform,formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: _ t9uSe... 4�� '- eAaml. (dry cleaners) .s�, Other cleaning solvents Bug and tar removers oeODA Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 R,RMA.q $ 200 Main Street• Hyannis, MA 02601 �'OrfOww+°�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C e 4$ Re.Re.5 c,r� Date: 7 / Location/Mailing Address: es r ah n r Contact Name/Phone: o yn _ —Inventory Total Amount: "��SD '� I MSDS: Y0 C4 License#: Tier II : Labeling: 01<- yD5 Spill Plan: Oil/Water Separator: Floor Drains: 10 Emergency Numbers: S Storage Areas/Tanks: o , A-r� W ar, Emer enc /Containmen E ui ent: 1041 P&ML G,/ c1�\�1aw Waste Generator ID: A Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: \ LIST OF TOXIC AND HAZARDOUS MATERIALS O a VAA.'r ^� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material %se, � - 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(aotl,c.5.vi 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: &4 ty r~-kL-( 6 5k-tv-.- Y oo t.- w �. o mac. Ci—�r " 1tia a1 �'S � 1 1 GaVu-fib 1 \D�4 , 1rCt f,r �� v �'2a v Inspector: / �j ate �Corb�k C`&%uS OLW �,c&ootL��o��k,�,acility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i °Ft ►off Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. MASS. $, 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: g9 ks Location/Mailing Address: X21111 S+ y4V1,115 Contact Name/Phone: SoS- 7 - 4 qL4 III GI�c o►�- Ok 1,5 k— Inventory Total Amount.� D=�,_t�l MSDS: - e-S License#: t� Tier II : ` I Labelina: a, Spill Plan: Oil/WaterSeparator: Floor Drains: S E eriaency Numbers: 0K Storage Areas/Tanks: ANI a� Emergency/Containment Equipment: D ti IL !00,A 2-�S �C'c 1 r�A C' e_ �V,,I, � ua mk ZA I ro&wt. Waste Generator ID: MIA Waste Product: Date&Amount of Last Shi ment/Fre uenc : Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS wtst 1v!�uvg t ►�, �vtV�w S�ti� Ic��j.�- It.'f NOTE: Under the provisions of Ch. 111, Section 31, of the General Lawn¢of MA, hazardous rnihterial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 9 P 9 q 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/ yt\fe,% 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 V 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: M CO INFORMATION/RECOMMENDATIONS: 05 5 � Vl 1ti � 1A. rk 1 k4 T (,Q vG b ab Nn. Inspector:_ ' , Facility Representative WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS Imo-__ - TOWN OF BARNSTABLE ��s Date: `1l l2,5-1 7 TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: CApy, 010,L_keeaork BUSINESS LOCATION: (0�1 GJ�,�� ,Ma„�, H�/QKN�I'3 INVENTORY MAILING ADDRESS: TOTAL AMOUNT- TELEPHONE NUMBER: ,5O�-?-75 - q qq ^-,2(Z �e)l CONTACT PERSON: XVl a Sort, ol�►n, La►� ck �►nrs •� w EMERGENCY CONTACT T LEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: ow405, eS INFORMATION / RECOMMENDATIONS:►� ec%Kxk) Fire District: '0,k� Phu ^ >►� sw--rm,} SAe pc2 vewm 15 C�►�-►n1►c al s-�ocaa, �'a c.��31 cc.ek pco��� o� vo.� �a�.`4��ss bl e`,�r Z CQ Dock-re4 7 1,,&r Z`Vr-. Ort, Waste Transportation: NIA - V1)j- \Aa.-14-4ovs Last shipment of hazardous waste: Name of Hauler: w aA-p- c-A--Fcgv694! Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 1, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month re wires 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 Z ❑ NEW ❑ USED Z- (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'ae5weg S 1�0� Swimming pool chlorine 11.,5°/o Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar \a�0 PCB's Paints, varnishes, stains, dyes' � �o�oew Other chlorinated hydrocarbons, Lacquer thinners �Sw� (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 M�y4 c1u� S to a1 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 Applicant's Signature Staffs Initials 1 J L. 1 Number Fee 1225 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Premium Auto Body 657 Yarmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 :r r Vwofor B4rnsxable eg atory Services �t r Richard V. Scali,Director � A� " Public Health Division BABSTABLE •. � 0� BArNSTAEIE.[F?lfE1MLLE.COitIR.NyNlN15 ASTABLE, • Thomas McKean, Director "'�1�"a<�� 5, 200 Main Street, Hyannis,MA 02601 fag 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 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 9 vI S 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. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,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. 4. FULL NAME OF APPLICANT: iO ' Gd I dJ 11 5. NAME OF ESTABLISHMENT: M V!n y2 u b acC 6. ADDRESS OF ESTABLISHMENT: eZA hAQ J70 V2 10 C 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: �'` �U� S7. vow 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: t2 9-e rn ty m 4� �(U a� 10. SOLEOWNER: RYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD S,AND TELEPHONE#OF: CORPORATION NAME P rn I v`rY� t-> 0 C. PRESIDENT TREASURER CLERK 12. IEF PP D BY OUTSIDE PARTY:NAME � [TELEPHONE#: 5<)-b t rJ' 2 z Z iCOMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE �/ s QAApplication FormsUiAZMAT APP 2017 • I ocx JUN 20 2017 pm 12:15 Number Fee 1225 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Premium Auto Body 657 Yarmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 ow of B instable �� C601 �I J611 T -Regulatoryervices �` T Richard V. Scah, Director O ^ Im C P` "+ Public Health Division BARNSTBBLE M dnkNStnBIE••.-mfERVILLE•`C ERV1 ,1,T•i1Y41.iN5 i tukclWtS MIf!5.OS1 � iSi R?J.NTSpLF BARNSTABLE, Thomas McKean, Director 639-201 9 MASS., �'ATFDMP�a`0 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 � � Fax: 508-719-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPf 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 30th). APPLICATION FEES CATEGORY' 1 PERMIT 26— 11 Q Gallons: $ 50.00 X �' 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. 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. 4. FULL NAME OF APPLICANT:?10-e m l t9 yn 0 V�� 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: ✓ �Z 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:8. TELEPHONE NUMBER-OF ESTABLISHMENT: a I 7 2 22, I . 9. EMAIL ADDRESS: CJ fO ✓ �vf 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#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE o 6 '� ® Q:�Application Forms\-1AZMAT APP 2017 REVI"*D.docx Number Fee 1225 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 �I Town of Barnstable Board of Health This is to Certify that Premium Auto Body 657 Yarmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons 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. 04/15/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Number Fee 1225 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Premium Auto Body 657 Yarmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 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. 06/30/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable • F� ►° Regulatory Services Richard V. Scah, Director t3�.�t vJ c B MASS. = BARM BLE $ Public Health Division s63q. ��0 MAPS'0 SB 4.OSiEl �W�T BA ISLE AIFD""°s Thomas McKean,Director 16 �g4 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 �1Qa 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 ❑ 4 A late charge of$10.00 will be assessed if payment is not received by July 1st. • ASSESSORS MAP AND PARCEL NO. DATE 05 - Z � [ FULL NAME OF APPLICANT: %a L,I; X-to NAME OF ESTABLISHMENT: 2in P Yn 10 1111 k2 Q-N� C_ ADDRESS OF ESTABLISHMENT: (a?VM<) th 0'-A in•71, . MAILING ADDRESS (IF DIFFERENT):�' [j �� w� S^T . I�� ►�1?�/5� TELEPHONE NUMBER OF ESTABLISHMENT: 06 2 2 2 EMAIL ADDRESS: �7 Pv��t,r►� �0 �l�e . Cow SOLE OWNER:_3�'YES_NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: �IJATURE JAPPLICANT Name: Company Address P Y Telephone#: Email: Q:\Application Forms\HAZZAPP Revl6.docx Page 1 of r r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 • sAxtvseABM Public Health Division MASS' Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt 11-lazardous Materials Payment received: $69.00 (Cash) on 5/25/2016 --� � � - I j I Business: Premium Auto Body Owner: MANUEL J ESTATE OF BRITO I ;Address: 657 YARMOUTH ROAD, Hyannis i ote: $19 Pro Rate + $50.00 2016/2017 Category I Permit � • • \ COMPLIANCE: CL SS. 1. Marine,Gas Stations,Repai.r "OWN. OF BARNSTAbLE \ 2. Printers I BOARD OF HEALTH b satisfactory � 3. . Auto Body Shops ,unsatisfactory- 4. Manufacturers w (see"Orders") S. Retail Stores COMPANY � JJT �1- 7 n 6. Fuel Suppliers ADDRESS Class' 7. Miscellaneous NFAMMENEM ! a - QUANTITIES AND STORAGE (IN=indocrs; OUT=outdoors) U l �YCa e lots Drums AboveTanks Underground Tanks MAJOR MATERIALS IN IDUT 'IN I OUT IN IOUT 21 e rest? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) ro _•- Heavy Oils: f/ waste motor oil (C) ' new motor oil. . . (C) f transmission/hydraulic Synthetic Organics: I degreasers ; f Miscellaneous: D I S p 0 F.A L7 RECLAMATION REWAKS: 1. Sanitary Sewage 2. Water Supply - OTown Sewer Public ,; " �.'S ,,,. -' ..'— tom .�,a On-site Private 3. .lnhoor Floor Drains: YES NO 7�"' - �• Holding tank: MDC -_ 0 Catch basin/Dry well -•-----�_._ _ .._ ..-----•--.__.:_...-- ------ — 0 On-site system W . ,A 4 rVNI ; 4. Outdoor Surface drains:YES NC` y ! i oldi tank: MDC ` i - 0 H ng . O Catch basin/Dry well � �*"• -- T --- , OOn-site system S. Waste Transporter r/ �# Licensed. Name of Hauler_ „jZ s i na "` .f 2. �,. Person s) Interviewed 9sp• .t' r Date 12 23 91 1 r, s-- TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: ` oef Board of Health MAILING ADDRESS: e k Town of Barnstable TELEPHONE NUMBER: v`�-� � P.O. Box 534 CONTACT PERSON: Hyannis,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 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 i lease put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners :]rEngine and.radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants #2 heating oil 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 Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, 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 orr 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 O satisfactory 2.Printers BOA D OF HEALTH 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY R (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS lass: 7.Miscellaneous UANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATER Under . , , Tank IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) 1 , 2 (g) �Q Il Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic 7 / �✓' Synthetic Organics: degreasers 44 �. Miscellaneous: &21�4"dla4 9 0�;? 16W"A DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer Public �VOn-site OPrivate / � 3. Indoor Floor Drains YES NO lam , O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS.- 0 Holding tank:MDC 4s O Catch basin/Dry well , O On-site system y .11�R 5. Waste Transporter Name of Hauler Destination Waste Product 1. 2. Pers (s) Interviewed Inspector Date TOXIC.AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS�2f AO`I L Z Board of Health MAILING ADDRESS: �'� ��' t 1. Town of Barnstable .TELEPHONE NUMBER: ;7 57 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 - 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 gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil 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 Car waxes and polishes Jewelry cleaners �sphalt & roofing tar Leather dyes faints varnishes stains dyes Fertilizers if stored outdoors aint & lacquer thinners PCB's aint & 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 ;Y 1Ya � ,,..,, ��„sw.�►yp4''� ��r,.'X'A.v M 1....:� +"'6"� �` ^�war:. ,� :4+ ^-P=cs..� ','�.�-n..ns::.,;. u+z• p.--r.h+'•�.. A rV a. TOWN OF"BARNSTABLE COMPIJANCE: class: 1.Marine,Gas Stations,Repair 2. nte BOARD OF HEALTH O satisfactory 3.Au Body Shops unsatisfactory- 4.Manufacturers COMPANY 'X%v ?"r� � (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ��r7 "MQ� /r 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 -277 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 A : t , Miscellaneous: rr fir' t r U DISPOSAURECLAMATION" REMARKS: L Sanitary Sewage 2.Water Supply �-4-"'trf' �'WA 1-r O Town Sewer OPublic y Y 0 On-site OPrivate 3. Indoor Floor,Drains YES NO �'�. / r 0 Holding tank:MDC # s ' 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO /-" ORDERS: 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Person (s) Interviewed Inspector "r / Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: r 9'' Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: 72Z-!f Z!!� 5/iir P.O. Box 534 CONTACT PERSON: lira.,s- �4,-V- 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 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: , ,�.r• TELEPHONE: D ` 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: 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 Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants _ creel, kerosene, Pesticides (insecticides, herbicides, _ C 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 Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes �C Paints, s Fertilizers (if stored outdoors) _ c 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) /2p�Cc/ E&Z/% Other cleaning solvents 4-0, lv4e e e J 4Zeaa eel 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 ,BOARD OF HEALTH satisfactory 2.Printers � 3.Auto Body Shops Iq a ( O unsatisfactory- 4.Manufacturers COMPANY -� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Z,5_7 Class: l 7.Miscellaneous UANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIA S Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Ke osene #a{Bj' Y Heavy Oils: waste motor oil (C) new motor oil (C) /`Cs 1° transmission/hydraulic Synthetic Organics: degreasers —?� b 41�tl Miscell eous: � le' A Pam, - 444v DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer kPublic On-site O Private 3. Indoor Floor Drains YES NO fJ O Holding tank: MDC O Catch basin/Dry well AV O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product '( j'��j ;Rht YES NO 1. U ro it 2. �z-z - Person (s)IntervieNf'ed Inspector - Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM • Mail To: NAME OF BUSINESS:4 �U��� ��"� � ������� Board of Health MAILING ADDRESS: f'e`2otQ� 3o�1�ur�i f� Town of Barnstable TELEPHONE NUMBER: ` l/�' � 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 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 A AZARD S MATERIALS e f H - It med th ll g-p exhibit toxicor h ous c I les Ufa III ng mo`re-#h Irquid volua` r_ .pou s d g t. Please put a check beside each product that you o e: 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 Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heatingoil 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 Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes 451�.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): ry cleaners) e4eahcj- /Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business _ p �-.k" *ea n r�R T'u'c'Z."o-"w-e.,...r,•,j � e�y.:.w•w.«;� ,�* _ ,.•S+, " � �Y•Y 5,:1'"' „=.R.'- ,�.fT .. :t�'-rs�ni.x•"^.r'^Mk'�.. r'.r..,'�"•7 .^en'W,r.t.�^. --..rr vy.:Y,-' r�r.w.'vi�..t..-atr�,'4`-,;,v,r , TOWN OF BARNSTABLE COMPLIANCE: " CLASS: 1.Marine,Gas Stations,Repair ® satisfactory 2.Printers BOARD OF HEALTH r 3.Auto Body Shops ",V' unsatisfactory- 4.Manufacturers COMPANY�..t"t t�`t'4` - �' �'e?,- 4 O (see"Orders") s.Fuel SStores pl ers ADDRESS I V-rO 4 &,,- Class: 7.Miscellaneous 44'013 4 00�41 ey? 06-`o ;-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,12.(B) Heavy;0ils: waste motor oil (C) � , new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: y r DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supplyr O Town Sewer. O`PubIic r O On-site OPrivate 3. Indoor Floor Drains YES NO b O Holding tank:MDC O Catch basin/Dry well "If i O On-site system j 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination 1. �''r�_'ie'� !' � ' ,u�'7' �,6�'"� �'./!c�.�/.} //�� ��,,,•( YES NO,.,. 2. 1� r :.s'"'"7 � /.G:'-,s..-;r:��....*'" ��fir.,-�,r� � '"�•'�^'I�i'+� �� aRi�r��'„�`,•`r�,P� Person (s) Interviewed Inspector Date