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1680 IYANNOUGH ROAD - Health
a53-oI t ��� y °F IKE rok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RARMA.11; . ' 200 Main Street• Hyannis, MA 02601 i639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 Py Business Name: 6LKvt t &0 C0%>r5.e. al pcE g Date: Location/Mailing Ad ress: IG90 V4LKK^tj8 L 4—>_V. gyqV%6 1 ItA44-ft Contact Name/Phone: e era Ja.4.e s ger°}l'e,y Inventory Total Amount: ^l l V7V 4 ILL yt1SO Ib SDS: �/G S License#: Tier II : Labelino: P Spill Plan: 1615 Oil/WaterSeparator: olk Floor Drains: 100 Emer enc Numbe s: ZS Storage Areas/Tanks: 2-$00 Y( t a S al cvrc5 Emergency/Containment Equip ent: Wk- \04 A&a S09 Waste Generator ID: A V 5b A 36 3y16 Waste Product: Date&Amount of Last Shipment/Frequency: 'r-Gb Zo 16 5,0 'Iwj Licensed Waste Hauler&Destination: C�/K. Other Waste Disposal Methods: o AA& n.� GSA tw IKVr?K o� LIST OF TOXIC AND HAZARDOUS MATERIALS ( y NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous m/terial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids 7 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 V Diesel fuel, kerosene, #2,heating oil Disinfectants is'-ce la eons petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages �` Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Z Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers � Leather dyes Miscellaneous Flammables V 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: S 0 t 5eV&6 -?.LOyKVk�2 q, �att, INFORMATION/RECOMMENDATIONS: I Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS IB►ogti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABNASTSA�BLE.g` 200 Main Street• Hyannis, MA 02601 ,b,q TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Business Name: 6Q4 Date: 917.1111. Location/Mailing Ad ress: �01Q1 68 Contact Name/Phone: eK So - 62- Qry f�� ir%X + ' Y. , c- sF.c., W�,�ow tilco�r�, Inventory Total Amount: 11a� 11$�d�� MSDS: 'S License#: IS'-(' W3 Tier II : f�o Labeling: 6&o A Spill Plan: e-5 Oil/WaterSeparator: IPA Floor Drains: 1�o Emer enc Numbers: Ye-, Storage Areas/Tanks: 2-Sco o�1 �-Ty �� ,ti ti� ,� +.�,r,,�.�k as cam-I 5S RI ekcaoks- e.1 Emergency/Containment Equip ent: i 1 le, 5 w, �0co,n,,5 .Q - 4.14 g Waste Generator ID: Waste roduct: oil . 4A3C.�re��Zr�c�eq,�.e 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 `i 2 Other cleaning solvents&spot removers O i I Ux.51 Engine and radiator flushes � Bug and tar removers Hydraulic fluid (including brake fluid)Z Windshield wash 1 1 .4,W Motor oils ws �X, Miscellaneous Corrosives aS u a � v o Gasoline,jet fuel, aviation gas° " 59, Cesspool cleaners S'o0 Die a del, kerosene, #2 heating oil p,?9y Disinfectants Z Miscellaneous petroleum products: Road salts grease, lubricants, gear oil ,ti 1 Refrigerants k Degreasers for engines&garages \5 Pesticides: t)o w,A.l Caulk/Grout insecticides, herbicides, rodenticides 4- Battery acid (electrolyte)/batteries t 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 Lye or caustic soda t i Lacquer thinners I Miscellaneous Combustible S4ere.,. Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables t-1 b Fertilizers 0 15�o kka 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: v�. car S taut r �w� 1_avc l�v ,* Inspector----I L a-VjAk Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS 09/01/2016 20:35 5083628878 HVANNISGOLFABA PAGE 01 Please Print Or type.(Form des ned for use an elite 12-pitch)typewriter,) UNIFORM HAZARDOUS I.Generator ID Number Form rOft OMB No,2050*30 WASTE igA1tAFE$7 , Z•Page 1 M 3.Emergency Reaper Phone en at ng Number 5 Generators Name and Maihng Address r - 1.800.8994 038 B F uorwftre SnbAddrees(if dlffierent than mining adfheas) Genaratofg Phan; 8.Tranepop,,1 ColCpany Name CYN OIL CORPORATION �, tPAIDNumber �.Transpo ter z company NameI MAD 0 8 2 3 0 3 7 7 7 U.S.tePg 10 Numlaer 8.Designated Fadity Name and 81teAddles8 U.S.EPA ID Number CYN OIL.CORPORATION, 1771 WASHINGTON STREET,STOUGHTON,MA 02072 Facul s Phone: 781.341•510$ MA0062 3 03777 9a. Ob.U.S.DOT Dewtgon(indr.ding Proper Shipparg Name,Hazard Class,ID Numher, 9 GP(deny)) ID.Contanars HM and packing den 11.Total 12,Unit 13.waste Codes i• No• Type Ounnlay 4N.Not. oC Q STATE.REGULATED OIL WASTE w�IA9$ u.r 4 2. 3 4. 14. paeal Hmhdgng nslructions and Admtlanelinfonoe on 24 HOUR EMERGENCY SPILL RESPONSE 800.899-1038 D.O.T. EMERGENCY GUIDt#128 PASSED DEXSIL 16. GREWORVOFFEROR'S CERTIFICATION: I hereby dedarg that'hs contents of this conaignmer4 are fully and accurately described above by the proper shipping rame,and are claa®fed,packaged, marked and labsedlpldraroad,and are ht ap rtsp6Ga in prupw ourdhiun for transport acreording to applleable Irrtematioral and national gownmentaf ra lilggna.If export shipment and I am the Primary Eepatet I tbrtdy that the contents of thla=R19nmem conbon to tha terms of the attached EPA Acknawiedgmopl of Conaerd I certify that the wash mlldmlza8or a tamart:ldardried it 40 CFl(H I am a large quantity gerterstaq or(b)(O 18m a wall quenffiy generderl Is true. Gonaramr •erors PrintadlTyped Name Slonator1r, y Month Oap Year 16.Intemationa Shipments ❑Import to U S. ❑Export fan U.S. Port of entrylgx8 !� _ T-ansprnter signstura,for exports only):. Data herring U.S.: 17.Transporter Acknowledgment of Receipt of Materials TreneQoner t PrintedRyped Name Signature Month Eley Year •r LJ Uaneporter 2 dnted+ryped ante Slgnsturq. Month Day Year 10.Dlacrspancy 18a Diaorapency Indcallon Space ❑ Qmty ❑Type ❑Residue ❑Par6el Rejection ©Full Ralw1w Manifest Referan4re NwDel; 13b.Alterh9le Fadaty(or Generator) U,S.EPA ID Number R? Facillt/s Phone: 1ft Signature of Apemate Fadgty(a Generator) MOMh Day Year 19.Hazarcous Waste Report Management Method Codes(i.e.,odes for haza*w warwa treatment,dapoaal,and recycling systems) 20.DeBolod FacIINy Owner or Operal ,Certifeation of receipt of hazardous matarials coWad by the manifest ego*so Mod in item I Be Printeoftypea Nema nature th Day Year EPA Form 8700-22(Rev.U5) Previous editions are Dbsdete. GENERATOR'S INITIAL COPY °FtME rokti Town Of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMSTABLE.g' 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CFO MAC Business Name: 1S G2,W l_.0or5-p— — c�Q.navv�e_ Date: 3 rz� lS Location/Mailing Ad ress: I L-90 ah r wta,1' 0$o M.M M. Contact Name/Phone: I nventory Total Amount: -71% q� MSDS: `�/e5 License#: 1 S Lf Tier II : 0 l Labeling: 6'oe,X� Spill Plan: e 5 Oil/WaterSeparator: tj Floor Drains: J Emergency Numbers: e-S Storage Areas/Tanks: - oo a 1 o� �� a� r� 4icsol,,�e ,P 1 Te4�,�s M&rcj Emergency/Containment Equip(nent: •1k \a, s 11ae $ ava.l� F�anwcalo, s coriA �g1d l Waste Generator ID: 1<0 $ q 6 Waste Product: ,0 ByLf, t2e Date&Amount of Last Shipment/Frequency: G ' � 5-0 , r So al a-vf-Vote - o 4 , $ Licensed Waste Hauler&Destination: K- V, I 5+0v �o - Other Waste Disposal Methods: �a'r `' Gl�a v�.c �! - C.l•eav-k'X -,z Yr5 LIST OF TOXIC AND HAZARDOUS MATERIALS 0 a ,�a�vl aka`�`�5 ,,� KAV_A-a .Sivt CO—14 if- I V.s�'lo%-- NOTE: Under the provisions of Ch. 111, Section 31, of the General LavA of MA, hazardous4aterial use, 31?ol�`f storage and disposal of 111 gallons or more requires a license from the Public Health Division. !�o Antifreeze - So 14_1 kJ-A_^^3a.9+� Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 50 Hydraulic fluid (including brake fluid) Windshield wash Motor oils -So *q{.6 Miscellaneous Corrosives d0 Gasoline,jet fuel, aviation gas Cesspool cleaners 00 Di se el kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants 19 Degreasers for engines&garages V?4 Pesticides: -1'�a,l�rlCowfia�w¢! �,%6141Q Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners �— Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: No .< Cf- rv\M-LA at,0 n ZKi5 v---C Inspector: La-\,Ja11,2� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 31901 I q TOWN OF BARNSTABLE=10K-- TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: A I ► _ BUSINESS LOCATION: Ib$0 lygr„o,x.t 1Qj, &lns 4,61e- � XbS INVENTORY MAILING ADDRESS: '"� ' 1 TOTAL AMOUNT: TELEPHONE NUMBER: Coy S .�1280 AjI CONTACT PERSON: 43(-. c,Q sy 36t90tb EMERGENCY CONTACT TELEPHONE NU BER: l�ky - /►'(a col► - f�wea�s MSDS ON SITE? TYPE OF BUSINESS: Powi L�G-ram- ve,S INFORMATION / RECOMMENDATIONS: " 4S 6k-CAA,* Oflt< Sk Z Fire District: n Oo y o ,l f-eeerHr'tEK �eKS 1s41&4f-, ti�,��y„ Waste �� & ✓�o836gSYro Last shipment of hazardous waste: ' �� Name of Hauler: Destination: 6'ovc*k}oo— Waste Product: ���-e. o, Licensed ►No hk>0oZ�o�777 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 —/yirte� �c g i�./wei• cna,gc�/ �►c5 -N,o cLi�► The Board of Health and the Public Health Division have detern-i elS45 e rfilowing products ex'lib t toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum ;Q> Antifreeze (for ga line or coolant systems) Miscellaneous Corrosive Antifreeze 3 0 USED �� - Cesspool cleaners 3 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) sS Hydraulic fluid (including brake fluid) Refrigerants Motor Oils /USED4,�'�'t l Pesticides p G� NEW f" U '" ' (insecticides, herbicides, rodenticides) DO Gasoline, Jet fuel,Aviation gas v�` Photochemicals (Fixers) Epp Diesel Fuel, kerosene, #2 heating oil vs-f' ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) 10 lubricants, gear oil ❑ NEW ❑ USED 1 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) `p Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes g,vL f 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 Applicants Signature Staff's Initial