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HomeMy WebLinkAbout1800 IYANNOUGH ROAD - HAZMAT -1680A Iyaniiough Roacf/Route 132 f. ' Barnstable A = 254-016 i 1 Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 11"YA"IS 604,0:= BUSINESS LOCATION: -, AS INVENTORY MAILING ADDRESS: 4r 00VC TOTAL AMOUNT- TELEPHONE NUMBER: (a -o' 15z;(. Ll/r C14-U PAJ CONTACT PERSON: $gam s ��44ASDS N TEMERGENCY CONTACT TELEPHONE NUMBER: O SITE? TYPE OF BUSINESS: ?U,0Ue GOeF � L� INFORMATION/RECOMMENDATIONS: /lshS ®.y -517-E 5PIc4-�"' A Fire District: S!T� (9*77W46A�J�j t>� Vas�. W4Qf?Z-0/L bok--0 -rS �t�JD /�Z�q�- Bq-,9A67X6 : B AtS _S77eAc76 �t�'- TD regZ n /YAV 111PE1 111-0VS -"04- I)XccA( 01-' NY 77tt 7)a HP5 M-fZ ry s€ s 7pAjo /,4/o0o,es, A-N A-4 yj&V quo Waste Transportation: Last shipment of hazardous wa Name of Hauler•SAj 4-�1c- Destination: � bar st. MA) �3T- Waste Product: WA-s A1-9vs)7946 Z",In Licensed? es No r NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials 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. . `o -01KHgz. kA7. s rVieA f Observed/Maximum Observed/Maximum k jj� be—vRs uAtI<Vowd CHi4. lEXt L Antifreeze (for gasoline or coolant systems) Misc. Corrosive sPowirs?) oe ►c H1,11-c- D S NEW USED Cesspool cleaners W/ '"Vire a" - s'�"'T oFr- Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) S Hydraulic fluid (including brake fluid) Refrigerants Motor Oils .S Pesticides (Awl' 119 NEW OUSED (insecticides, herbicides, rodenticides) Gasoline, t fuel. Aviation gas Photochemicals (Fixers) lesel uel, kerosene, #2 heating oil NEW USED Misc. 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 7:iV1t7Z5rA1i- jkkea-s be-® g Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers (,ko DSa 1'dUuOSI Asphalt & roofing tar PCB's / Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners - (inc. carbon tetrachloride)_ NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables. ;:I A4,k4 i3fs&S hydrochloric acid, other acids) C�4-3r�tjT' Floor &furniture strippers I Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers 6 ,� Gn.C� ble�,H 1::�Vj?- B hJC51S 6/L (including bleach) I,:::/LTA Spot removers &cleaning fluids lwOwiJS /-/kF_ Z!a CeU,1 ZAZ: (dry cleaners) ayaIJS Re1w&X­d1(-tC4uH Other cleaning solvents go 6,A-1-Z41J5 Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANAR COPY-BUSINESS 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1680A Route 132 Hyannis Owner's Name: Hyannis Golf Course, Maintenance Facility Owner's Address: Date of Inspection: 3/26/2007 O Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O. Box 371 Sandwich,MA 02563 Telephone Number: (508)888-6055 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The System: ___�/Passes Conditionally Passes Needs Further Evaluation by the Local Authority Fails �, /f--- Inspector's Signature: �-'� �,��I Date: V114 k The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of I0,Ob0 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of-the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and-the approving authority. 1, Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: �I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"secti need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the for the folio mg statements.If"not determined please explain. The septic tank is metal and over 20 years old*or th eptic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank approved by the Board of Health. *A metal septic tank will pass inspection if it is s turally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old ' available. ND explain: Observation of sewage bac p or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a b en,settled or uneven distribution box. System will pass inspection if(with approval of Board of Healt broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: e system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pas ' spection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Y Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determ' the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 R 15.303(1)(b)that the system is not functioning in a manner which will protect public health,s ty and the environment: _Cesspool or privy is within 50 feet of a surface water _Cesspool or privy is within 50 feet of a bordering vegetated w�nd or a salt marsh 2. System will fail unless the Board of Health add Public Water Supplier,if any)determines that the system is functioning in a manner that protects�the public health,safety and environment: X _The system has a septic tank and spil absorption system(SAS)and the SAS is within 100 feet of a �surface water supply or tributary to, surface water supply. The system has a septic,tank and SAS and the SAS is within a Zone 1 of a public water supply. _The system has aseptic tank and SAS and the SAS is within 50 feet of a private water supply well. _The system4 as a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private waterfsupply well**. Method used to determine distance . **This,system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria�and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool p� Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ O Static liquid level in the distribution box above outlet invert due to and overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than%r day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ A; Any portion of the SAS,cesspool or privy is below high ground water elevation. 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is 50 feet of a private water supply well. _ _4L Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system.the system must serve a facility with esign flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the follow' (The following criteria apply to large systems in additio o the criteria above) yes no the system is within 400 feet o surface drinking water supply the system is within feet of a tributary to a surface drinking water supply the system ' ocated in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II a public water supply well If you h e answered"yes"to any question in Section E the system is considered a significant threat,or answered "ye " Section D above the large system has failed.The owner or operator of any large system considered a gnificant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. , Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No °D Pumping information was provided by the owner,occupant,or Board of Health ,QQ Were any of the system components pumped out in the previous two weeks? _ Has the system received normal flows in the previous two week period? _ ? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? _ Were all system components,excluding the SAS,located on site? _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Was the facility owner(and occupants if different than owner)provided with information on the proper maintenance of subsurface sewage disposal systems?` The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] I Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1680A Route 132 I. Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedr s(actual): DESIGN flow based on 310 CMR 15.203 (for ex e: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grind es or no):_ Is laundry on a separate sewa stem(yes or no): [if yes separate inspection required]. Laundry system inspecte es or no): Seasonal use:(yes o): Water meter ings, if available(last 2 years usage(gpd)): Sump P p(yes or no):_ L ate of occupancy: COMMERCIAL/INDUSTR AL Type of establishment: Design flow(based on 310 CMR 15.203): _ gpd Basis of design flow(seats/persons/sq.ft.etc.):Apt? Grease trap present(yes or no):fiLl Industrial waste holding tank present(yes or no): +�1 Non-sanitary waste discharged to the Title 5 system(yes or no):hLi Water meter readings,if available: ` 4)t;- 14 9,;;6FD Y , Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records r Source of information: + Rete,-Jae Was system pumped as part of the inspection(yes or no): . k,r If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approx' ate ag of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):_ Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1680A Route 132 Hyannis - Owner: Hyannis Golf Course Maintenance Facility Date of Inspection: 3/26/2007 BUILDING SEWER(locate on site plan), Depth below grade: Materials of construction:_cast iron Z40 PVC other(explain): . Distance from private water supply well or suction line: ¢U1t4 _ Comments(on condition of joints v1ng,evtid ce of leafage,etc.): l�tf(1' 4 v, SEPTIC TANK:-(locate on site plan) Depth below grade: Material of construction: concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: F+4`14 Sludge depth: " Distance from the top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: I - +e MWI�J�'I 1 .. Comments(on pumping recommendatio s, inlet and outlet tee br baffle condition,structural integrity,liquid levels as rela ed to outlet invert,�7✓ide ce of�eaka ,etc.): GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction: concrete metal' rglass. Uolyethylene •_other (explain): Dimensions: Scum thickness: Distance from top of scum to of outlet tee or baffle: Distance from bottom of m to bottom of outlet tee or baffle: -Date of last pumpin v . ° •_Comments(on ping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART G SYSTEM INFORMATION (continued) Property Address: 1680A Route 132 Hyannis ' Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 TIGHT or HOLDING TANK: (tank must be pumped at time of mspec• ocate on site plan) Depth below grade: Material of construction:_concrete metal fib ass_polyethylene_other(explain): Dimensions: Capacity: ons, Design Flow: allons/day Alarm present(yes or no . Alarm level: Alarm in working order(yes or no): Date of last pu ng: Comments ndition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on.site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): F d, 1 > el l y PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or n Alarms in working order or no): Comments(note c ion of pump chamber,condition of pumps and appurtenances,etc): i t Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 SOIL ABSORPTION SYSTEM(SAS):__(locate on site plan,excavation not required) If SAS not located explain why: Typ leaching pits,number: 1 leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): f� } �/ CESSPOOLS: (cesspool must be pumped as part of in eti>n (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construc . Indication of gr dwater inflow(yes or no): Comment ote condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of soli Comme note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Loc��e all wells within 100 feet.Locate where public water supply enters the building. r / a r ;t a,;�4� n Page 11 of 11 r OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1680A Route 132 Hyannis Owner: Hyannis Golf Course, Maintenance Facility Date of Inspection: 3/26/2007 SITE EXAM Slope s Surface water Check cellar Shallow wells Estimated depth to ground water >_<; feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: Checked with local excavators, installers- attach documentation) Accessed USGS database-explain: You must scr'be how ou established the high ground water elevation: 0 . n+si-F Cap��e - 1-��rz►�nrT a nOAS \ — ®c - - ---- -- - - - � f i► Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable -� Board of Health This is to Certify that Town of Barnstable-Hyannis Golf CourselClubhouse ................................................................................................................................. 1840 Iyannough Rd., Hyannis, MA .....................................................................................................................•.................................................. Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. Restrictions: .................................................................................................................................................................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Number Fee 501 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable- Olde Barnstable Fairgrounds Golf Course .--.............................................................................................................................. 1460 Route 149, Marstons Mills, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. .................................................................................................................................................................... Restrictions: This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Number Fee 1108 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that TOWN OF BARNSTABLE- TRANSFER STATION ................................................................................................................................. 45 FLINT STREET, MARSTONS MILLS, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. .................................................................................................................................................................... Restrictions: .................................................................................................................................................................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health f Town of Barnstable Office: 508-862-4644 I Regulatory Services Department Fax: 508-790-6304 snrrsraSM Public Health Division Mom• Thomas A.McKean,CHO 'b39' 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received:$ 150.00 (Check) on 7/8/2020 Permit number: FY 2020 i I ICheck number: 1019775 Check amount: $450.00 Name on check: Town of Barnstable Business: Town of Barnstable - Hyannis Golf Course/Clubhouse Owner: TOWN OF (MUN) ;Address: 1841 IYANNOUGH ROAD/RTE132, Barnstable i i • i Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 HA SWIM Public Health Division MASSI, Thomas A.McKean,CHO ib39. 1 A 200 Main Street, Hyannis, MA 02601 Payment Receipt !Hazardous Materials Payment received: $150.00 (Check) on 7/8/2020 Permit number: FY 2020 ?Check number: 1019775 Check amount: $450.00 Name on check: Town of Barnstable t !Business: Town of Barnstable - Olde Barnstable Fairgrounds G Owner: TOWN OF (MUN) Address: 1460 ROUTE 149, Marstons Mills to • • ., Town of Barnstable Office: 508-862-4644 I Regulatory Services Department Fax: 508-790-6304 snsttvsMisM Public Health Division MASS. Thomas A.McKean,CHO rf 1659%, 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $150.00 (Check) on 7/8/2020 Permit number: FY 2020 � I !Check number: 1019775 Check amount: $450.00 Name on check: Town of Barnstable i !Business: TOWN OF BARNSTABLE -TRANSFER STATION Owner: TOWN OF (MUN) i ;Address: 45 FLINT STREET, Marstons Mills a I � F_7: Print Cert. ;t - Licerise 1108 - Acve Name. TOWN OF BA RNSTABLE-TRANSFER STATION Street no45 Street FLINT STREET Tbwn MARSTONS MILLS _' 4 Quantity 500 gallons or more z Malll(1 � . .._.� „� �-,mac m .�,. ,.. . "�-� ."'`.�'-.-,m-, �` _ »��` � ..s . g(if different) ' ay Year �ay Date°rp' Fe Address Town i � 2019-202 6/25/2019, $150.00 �_ I 2018 201 6_ /5/2018' $ 150 00 t ZiSate: 2017-2 jl 6/26/20171m $150.00 Phone 508-420-2258/patrick.kelliher@town.barnstable.ma.us - — 2016 § 717/2 0 1 6 1 $150.00 "-Restrictions' 015 6/30/2015 $100.00 �- 2014 7/15/20141 $100 00 �Xoriiments 2013 11/13/20131 $100.00 —r SAM s a Name: ;, F• , a z c r Street,no: 'Street: v Town:� . lit ll State: Zips s a, x e --7777=77— nn i Cent � License 154 . Active h Name: Town of Barnstable-Hyannis Golf Course/Clubhouse v - „' '. onsor�more :Street no: ,1840 Street: lyannough Rd. Town: Hyannis nb-� :Qua 500 gall Mailing(ifCFifferent) ay Year 'Pay Date Feee Address:s,1800 I annou h Road/mail to PO Box 68 MM Town MARSTONS MILLS }� Y 9 2019-202i 6/25/2 $150.00 _ State MA — }Zip:' 02648 - 2018-2011' 6/29/2018 — $150.00 ( ,g " 2017-201 � 6/22/2017 ���� $150.00 Phone �F__ -362-2606 --- 5/23/20161 $125.00 41 �- — ----- Reslxic ons 2015 6/5/20151 $100.00 .: 2014 100.8/8/201411 $ 00 _ _._..-,.- l Comments — `� �. _ a Name_ Honor Category II per T.L 2016 , a' Street no Street: Town: F, State `7rp w ... r— — e s 4 pa Phone: u. z �� s $ { a ee • pw - e 717 Print Cert a _ Town of Barnstable-Olde BarnstableFair rounds Golf Course License ; 501 Active Rj, a Name 9 Street no 1460 Street Route 149 T . P, s st � Quantity. 500 gallons or more q�nrn: Mar ons Mills +- � Mailing.(if different)""_' ay Year r Pay Date ' Fee Address: �PO BOX 68 `Town: ,MARSTONS MILLS 019-202 6/25/201911 $150.00 20187-20 6/291)2018j $150.00 State MA �Z�p 2017-201 __6/22/2017 $150.00 s Phone: I508-420-1143 5/23/20161 $125.00 Restrictions'" 2015 J6 /5/20151 $100.00 2014 8/8/2014 $100.00 Comments ' — -- .' 2013 7/5/201311 $100.00 • .. .. Name a Per T.L honor Category II 2016 R* Street no: J .Street: 4 . 6 , Town: a State — r" Zip. a . b Phone: TOWN OF BARNSTABLE \ PAGE:1 OF 1 CHECK NUMBER:01019775 .• a . e 06/04/2020 HAZMATFEE20200BF PARCEL 104"/003 T00 OBF GOLF-COURSE t ! PO#:20010756 GL#:618503-673010 1150.00 06/04/2020 HAZMATFEE2020HYA PARCEL#254/016 HYANNIS GOLF COURSE TOB $15000 'PO#.20010756 x GL#:628503-67301,0 $150.00 . r 06/08/2020 6 8 20 BARN TRANSFER STATION HHW PERMIT.. $15000- P.O#;200:10674 Gl#:637501 -6130.10 $150.00 r � 1 I milk,ml gm .®- • 4595 ?OINK!OF BARNS?AB EMEM LE ` PM06:125/2020 $450A0 � ( 1 1 i Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf Course/Clubhouse 18401yannough Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ----------------------------------------------------------------------- -------- -- ------- - - ------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN _D_ONALD_A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable office: 508-862-4644 {. Pax:508-790-6304 j Regulatory Services Department BA3iNg1AaI ; Public Health Division 9 MASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $150.00 (Check) on�6/a. t��r•� �_ emit n.� - er: .� yWyY c ( w_ /25/2019 Permit number: 2019-2020 Check number: 998731 Check amount: $300.00 Name on check: Town of Barnstable Business: Town of Barnstable Hyannis Golf Course Owner: TOWN OF (MUN) BARNSTABLE .Address: 1841 IYANNOUGH ROAD/RTE132, Barnstable `Note: Category III Permit • Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf Course/Clubhouse 1840Iyannough Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------- ------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health f r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax:508-790-6304 • �.EA Public Health Division M ASS. Thomas A.McKean,CHO Fo �:e 200 Main Street, Hyannis, MA 02601 Payment Receipt !Hazardous Materials Payment received: $150.00 (Check) on 6/28/2018 Permit number: 154 `Check number: 977776 Check amount: $150.00 Name on check: Town of Barnstable !Business: Town of Barnstable- Hyannis Golf Course/Clubhouse Owner: TOWN OF (MUN) !Address: 1841 IYANNOUGH ROAD/RTE132, Barnstable Note: 2018-2019 Category III Permit I i ... . _........ -._ ..... ......................... ...... . .......... .................................... - ----- ......... • • TO, N OF BARNSTABLE - - �INVOiC4 INVOICE s_ NET,INVOICEi PURCHASE INVOICE DESCRIPTION ,' , . DATE NUMBER AMOUNT ORDER#` � x ._ � . 5/30/2018 433036 HOLD HEALTH/HAZMAT 104/003-TOO ' $150.00 18010195 628403-673010 ( l �.-�� - VENDOR# VENDOR NAME vi CHECK AMOUNT CHECK DATE �CHECK'NUMB is 4595 TOWN OF BARNSTABLE $150.00 0\6/14618 l 977776 REMITTANCE ADVICE-ATTACHED IS OUR CHECK IN FULL SETTLEMENT OF ITEMS SHOWN HEREON. IF NOT CORRECT,PLEASE RETURN WITH EXPLANATION. Town of Barnstable Finance Department \ 230 South Street Hyannis, MA 02601 Tel:508-862-4654) Fax:508-862-4717 i / l 1 Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf CourselClubhouse 1840Iyannough Rd., Hyannis, MA 1s Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------. ---------------------------------------------------------------------------------------------------------------------------------------- ------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. - ---------------------------------------- S 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 'tm Town of Barnstable Office: 508-862-4644 ` Regulatory Services Department Fax:508-790-6304 • ; ,, , Public Health Division Thomas A.McKean,CHO .r 200 Main Street, Hyannis, MA 02601 Payment Receipt `Hazardous Materials Payment received: $150.00 (Check) on 6/22/2017 Permit number: 154 Check number: 956634 Check amount: $150.00 Name on check: Town of Barnstable .Business: Town of Barnstable- Hyannis Golf Course/Clubhouse Owner: TOWN OF(MUN) ,Address: 1841 IYANNOUGH ROAD/RTE132, Barnstable Note: "1840" 2017-2018 Category III Permit -------- . _- ....... -.. . . . ............ ... 1 aT M FBAR NSTABLE C INVOICE NET INVOICE PURCHASE INVOICE DESCRIPTION DATE NUMBER AMOUNT< ORDER'# .: . a 6/7/2017 390594 HOLD FOR HEALTH DEPT $150.00 17010328- 618403-673010 1 /0 4/b �Lnn rt n s i VENDOR# VENDOR NAME . ; CHECK AMOUNT CHECK DATE CHECK NUMBER' .,._ 4595 TOWN OF BARNSTABLE $150.00 06/22/2017 956634 REMITTANCE ADVICE-ATTACHED IS OUR CHECK IN FULL SETTLEMENT OF ITEMS SHOWN HERFEON.' IF NOT CORRECT,PLEASE RETURN WITH EXPLANATION. I Town of Barnstable Finance Department 230 South Street Hyannis,MA 02601 ) Tel:508-862-4654 Fax:508-862-4717 c r Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf Course/Clubhouse F(l V 40)yanough Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------- --------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2016 unless sooner suspended or revoked. ------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health rr �b 4 Town of Barnstable ofTow Regulatory Services Thomas F. Geiler,Director M"�`F- Public Health Division 'OtFON►a'�°i Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL N d ® 6 ATE lid ((5- 5� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS ,�pEsi FULL NAME OF APPLICANT -fr' NAME OF ESTABLISHMENT 4f_ /ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER FD SOLE OWNER:YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Oli660(0 STATE OF INCORPORATION I � FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK . SI ATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS I a}- HOME TELEPHONE # f: r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 • Public Health Division EA +73lABM *MASS. ' �► s ! Thomas A. McKean,CHO .� 200 Main Street, Hyannis, MA 02601 Payment Receipt (Hazardous Materials Payment received: $100.00 (Check) on 6/5/2015 ? f jCheck number: 912326 Check amount: $100.00 Name on check: Town of Barnstable I � !Business: Hyannis Golf Course Owner: TOWN OF(LB) BARNSTABLE (Address: 1800 IYANNOUGH ROAD/RTE132, Barnstable I i I I Ta ._N OF BARNSTABLE INV0 1042 INVOICE NET INVOICE 4 PURCHASE , ,F INVOICE DESCRIPTION DATE NUMBER - , AMOUNT ORDER# 4/30/2015 305137 HOLD FOR GOLF 104/003 $100.00 15010230 618403-673010 I I � � I VENDOR# VENDOR NAME CHECK AMOUNT CHECK-DATE CHECK NUMBER 459`5 TOWN OF BARNSTABLE $100.00 05/28/2015' 912326 REMITTANCE ADVICE-ATTACHED IS OUR CHECK IN FULL SETTLEMENT OF ITEMS SHOWN HEREON. IF NOT CORRECT,PLEASE RETURN WITH,EXPLANATION. Town of Barnstable Finance Department 230 South Street Hyannis,MA 02601 Tel:508-862-4654 Fax: 508-862-4717 �J J r Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf Course 1840Iyanough Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health cr �r F� 7-6 TOWN OF BARNSTABLE / Roc 53 "' i13 o FINANCE DEPARTMENT 403579e 230.SQUTH STREET._ � : CHECK BARNSrne� HYANNIS MA 02601 'v w�ss. NUMBER 039. .•� TEL 508-862 4654 l Eon - FAX:506 862-4717, **'ONE HUNDRED DOLLARS EXACTLY** L CleckUat'e �nA ountz , 05/22120.14 _ ► e VOID AFTER.90 DAYS TO THE ORDER OF: TOWN OF BARNSTABLE HEALTH DEPARTMENT 2.:Q;0 MAIN STREET HYANN,IS MA <:02601. TREASURER L II'89045 Dim 1:0 L 130447131: 403579Ba■ 5 : Town of Barnstable o� Regulatory Services Thomas F. Geiler,Director &UMSUBM + Public Health Division 9 MA95. $' 39. rEn Mns" Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00. ASSESSORS MAP AND PARCEL NO. I0q&0 3—7-0 L)DATE / APPLICATION F OR'FERMI T TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FEE,o Dfq 6BF FULL NAME OF APPLICANT 05 NAME OF ESTABLISHMEN (' 0L4VV �' �^ al-9 $)h ill c ,it /IS n Cocc ADDRESS OF ESTABLISHMEG �j I TELEPHONE NUMBER 50 �I � SZ 4;2 P 4 `-' g o ton► , SOLE OWNER: " YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPO"TION : FE'&RAL IDENTIFICATION NO. 6 OD1 oil! STATE OF INCORPORATION �SS FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS E TELEPHONE # O `r�0 Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Hyannis Golf Course 1840 Iyanough Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------- ------------------------------------------------------------------------------------- ---------------------------------•------------------------------------------- ------------------------------------------ ------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r i� f Town of Barnstable Regulatory Services Thomas F. Geiler,Director * 13ARN6rABM _ Public Health Division yq, MASS. ie ib39. �� TFo a►v+° Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:[$100.00 I ASSESSORS MAP AND PARCEL NO. DATE S� I 113 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF iWtARDOUS MATERIALS fF6'ao hj 1 yl} r—� FULL NAME OF APPLICANT L-�14 � 'Irvt's4r, o c©� NAME OF ESTABLISHMENT fil.✓ta/l,l C� ADDRESS OF ESTABLISHMENT 1900 -'L d'A('1()c,, K�an�^ �d�o TELEPHONE NUMBER 50� —�G —o) 6 6 SOLE OWNER: /YESF NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ��6 a0l STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER MV I CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS _ NNW TELEPHONE # 0� ? 003' L Date: 6, 3 • TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OFBUSINESS: 's BUSINESS LOCATION: (o acot 's MAILING ADDRESS: INVENTORY TELEPHONE NUMBER: 5-01?' 3& TOTAL AMOUNT: CONTACT PERSON: .L19 9.7s Npwa"5 EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOFBUSINESS: FIRE Ot57RICT' OTHER INFORMATION: P/ecz ae. 04re c�� A " .s -- c j oGr s M 505 'c s.a P� 3 LA C.4TIp ,-�j�.2 �trWh O'toGtrlRjryL2.,) �'� 77Jq�'fLl� �}�L/ Waste Transportation: Name of Hauler: 4d v. l tftsj:j;of rq Destination, Waste Product: p7;4, Licensed? �eNo .�-�'�" ba�e.�•ems... _' LIST OF TOXIC AND HAZARDOU,5 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 _Z Motor-oils :.y, Pesticides 6 am NEW ,MUSED (insecticides, herbicides, rodenticides) 2 Gasoline, Jet Fuel Photochemicals (Fixers) 20 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 ink Degreasers for driveways & garages Wood preservatives (creosote) 3 s Battery acid (electrolyte), (cxv+ft-u'es Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar1'00a! Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, PikNEW USED (inc. carbon te'trachloride)- &varnish removers, deglossers p ''17. 5S Any other products with poison labels Paint brush cleaners � (including chloroform, formaldehyde, Floor.&furniture strippers 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 Gea L c->,-/ Z T MiSC.: Wa.,w_ so-Ive.►-uk- -� Other cleaning solvents cs �— Bug and tar removers I/U/'/7ofT'alpl.lilllii Z''I'.Z r'" 'CooDate: fa 3 0 TOXIC AND HAZARDO S MAT RI ON-SITE INVEN Y NAMEOFBUSINESS: 14 t& 's BUSINESS LOCATION: 6 .s IN ENT MAILINGADDRESS: Aw •TO AL AMOUNT: TELEPHONE NUMBER: 5So1?- CONTACTPERSON: EMERGENCY CONTACT TELEPHONE NUMBER. f�l -r: TYPEOFBUSINESS: OTHER INFORMATION: ms" s o�+s Or M S OS oh wife - ab {-1+.e err, aToGs• ELF19 cN•�� �Aa�'D�i c,4,� Waste Transportation: ` Name of Hauler: Adv• Ltesuio rq e, c• Destination;- Waste Product: _ a,., A_cwe� Licensed? a No LIST OF TOXIC AND HAZARDOUrj 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 �Q1SED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt(Halite) Hydraulic fluid(including brake fluid) Refrigerants _y Motor oils Z Pesticides `'lam NEW -OgUSED (insecticides, herbicides, rodenticides) 25 Gasoline, Jet Fuel Photochemicals (Fixers) 20 aaA.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 ink Degreasers for driveways&garages Wood preservatives (creosote) 3 Battery acid'(electrolyte), tcq, -P.�.,'es Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar � Fertilizers Paints, varnishes, stains, dyes PCBs ✓ Lacquer thinners Other chlorinated hydrocarbons, 5- NEW USED (inc. carbon tetrachloride)- Pal'nt&varnish removers, deglossers - i `'1 S T Any other products wth poison labels Paint brush cleaners � (including chloroform,formaldehyde,- Floor.&furniture strippers - 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 �a,�Gea't' "`�� Z Ir MiSC.: i � 5ojve,,1, 1 7 Other cleaning solvents- c�s �— Bug and tar removers l ima �= 2, Go'n of Barnstable-Health Department • Pape 1 Z / HAZARDOUS MATERIALS INVENTORY SITE VISITS ^� DBA: Hyannis Golf Course Fax: Corp Name: Mailing Address Location: :.1680 lyanough Rd,Hyannis Street: Rte.132 OE r: City: Hyannis t: Russell Bragdon,Maintenance State: Ma e: :(508)362-8346 Zip: 02601 1'67,jA0L Person Interviewed:Contact Letter Date:Golf Courses Inventory Site Visit Date.Follow Up/Inspection Date:lic water ❑ indoor floor drains ❑ outdoor surface drains ❑d license required L ❑ private water El indoor holding tank mdc ❑ outdoor holding tank mdc 0 cur(:::::ce ❑ town sewage Elindoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- - ❑d on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: 6/3/2004 Remarks: 4/19/96 Parts washer-self maintained. All solvents in locked compliance: cabinet. Drained motor oil containers. Pesticides in locked,labelled Satisfactory storage room. MSDS sheets on site. Protective clothing,respirators on site. Pesticide records since 1985. Pesticide License. Proposed wash water containment system. REMARKS: 5/13/98-mp5083628346. Speedy dry on-site.Pesticide storage room labeled and clean. Interstate trades batteries. No rags C QJ�� service. All storage @ Maintenance Shed.ORDERS: Update M DS'scabinet REy Dry and oll -Store oily rags in metal cabinet with leds.Recycle Speedy Dry and oil filters. � y'�7G✓nl - C.9-- C� is &yj e V , a � • � ' 'e .` • i � ,e .. \ - ,' {. .f ,. . .. . .� � ) � j .. ti *.. _ . � � � � � � � I �u� c�' II ���'� �� �� _. . . � �� ,� . . , . � � . r - � . I v • �5NO P ,Sri L/v s - 1 � s 1 � LID I • 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 descrip#ion qty ' unit of measure T _ gasoline Ogallons diesel fuel,kerosene,#2 heating oil 1 :gallons waste oil —�110* allons motor oil _._..20 Ilons ........._..---... ........_.._................ ..__....... ...__._........ ._..............._....._......__._.._........._.........._. ___.........._...;..._.__._........................_......._.._....._...._..............._... hydraulic fluids(including break fluid) 10g Ions paint,varnishes,stains,dyes 20ga ons_ pesticides - — - -•••••- --- 30 gall ns pesticides 60poun s .....-_.._......_..._......___......_._-.._....___........__.._.._....._..______-_ .._-._____...._.,....._............._...._._..........___..............._......... _... antifreeze(for gasoline or coolant systems) 2gallon misc.petroleum products:grease,lubricants 1cases r�5 ..................._._.....-.__._.._......_.._..-___._._......------._...-_____-..._..._.._:....___.___,.._______-�-___........_._....._.__.__........-.........__....._ ._. degreasers for engines and metal 5gallons batteries/battery acid nn 2gallons Waste Transporter: W.Jl���•�°Ct�(C. Fire District: �G�/1I'Lf S Last HW Shipment Date: Waste Hauler Licensed: /a ��5 CA S t Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: Gzs-lt L .b Location: Date: S a i Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): 2. Waste storage areas: 3. Satellite accumulation points throughout: 4. HazMat stored outdoors — CHECK' OUTSIDE: 5. Shipping and receiving areas: 6. Run down of shop activities: 7. Housekeeping practices: HazMat On-Site Inventory/Inspection: /I ection: Records to Review for SQGs and CESQGs DBA: A" Location: Site visit date: 16 q • Hazardous Waste Manifests: • Employee training documentation (if required): • Hazardous substance spill control and contingency plan: • MSDS on site? • HazMat Inventory records (if applicable): • HazMat Waste Shipping documentation: Cam+ • Spill records (if applicable): TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Q�►�ll5 Got F C'dul5-c Mail To: BUSINESS LOCATION: Board of Health MAILING ADDRESS: Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: Z 'Z f�C? c(' Hyannis, MA 02601 CONTACT PERSON: f15 l 1_iq c d41 `- EMERGENCY CONTACT TELEPHONE NUMBE : �6 �� . MO Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, ' AMNjW 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 character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case 2604 Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners /0 Hydraulic fluid (including brake fluid) Disinfectants 16 Motor oils/waste oils Road Salt (Halite) 5 Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, /d" ue , e osene, #2 heath oil Z Pesticides (insecticides, herbicides, Other petroleum products:(:reR, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) er 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 Ca Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, -- -- Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business it • / • •LIANCE: CLASS: 1.Marine,Gas Stations,Rep • / • , / '' Printerssatisfactory 2. 3. . Body Shops • r i unsatisfactory- (see"Orders") 5.Retail Stores 6.Fuel Suppliers 7.Miscellaneous Case lots Drums Above Tanks Underground Tanks Ik 0 0 OMEN 1 . . "N , . . ; ffki Ak MENINSIM Ivm motorME A4kMEMEM new oil • Ulm! .. MENEEMEM ONA NAk INEEMIN NAZ MENEM !f NIIEZ MIN • "_ • 1 Reif01.01I Ad - TO r Name of Hauler Destination Waste Product Licensed? 1 m WI MW -, �,r fir• TOWN OF BARNABLE COMPLIANCE: ,S: 1.Marine,Gas Stations,Rep r BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY g)L"i" `f'f "f O (see"Orders") 5.Fu Retail Stores Suppliers ADDRESS 16 70 �yaM�w�Z, Ed Class: ` 7.Miscellaneous a� am. ��� °� d 14 QUANTITIES AND STORAGE (IN=indoors;OUT-outdoors) MAJOR MATERIALS CaSe,lots Drinns Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fue 6 asoline Jet Fuel(A) eise�_Lerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) 10 0 transmissio drauli Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply M 6Z 3 S ��' 4-4-et's6 O Town Sewer (Public rTUIX IC119t1W C&&4.11 t XOn-site OPrivate 1`¢-I. A,,-.v n f 5_-e-eu iN 3. Indoor Floor Drains YES NO� S , �, r/ �r'® 0 Holding tank:MDC_ O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC ¢i�• � � �' �.0 ✓�1 Sf 0 Catch basin/Dry well Pn-site system 5.Waste Transporter De Name of Hauler Sti t-ow, � � YES NO 2. Person(s) Interviewed Ti'speitor Date C TOWN OF BARNStBLE OMPLIANCE: C S: 1.Marine,Gas Stations,Repair BOARD OF HEALTH14, satisfactory 2.Printers 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY ,0 Af (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS AW ass: 7•Miscellaneous ' QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR TERL� ,• _ IN OUT IN OUT IN OUT #&gallons Age Test Fuels: �� Gasoline,Jet-Fu -FAY. Diesel, 2 (B) !/ Heavy Oils: waste motor oil (C) new motor oil (C) �� `p. transmission/hydraulic—7 Synthetic Organics: degreasers p 7 4.4, )V 4-;�z Ap? ZL z& iscellaneous: ,� - DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply ' tom' r c 0 Town Sewer "'Public A0On-site OPrivate 3. Indoor Floor Drains YES NOj1__ /) F 0 Holding tank: MDC_ �i✓� 0 Catch basin/Dry well 0 On-site system ' 4. Outdoor Surface drains:YESJNO 0 Holding tank:MDC XCatch basin/Dry well O On-site system 5.Waste Transporter &arne of Hauler Des4ina S NO Person(s) Interviewed Inspector Date I TOWN OF BARN ABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Q satisfactory 2. Printers BOARD OF'HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (,n 1 5 �� u (see"Orders") 5. Retail Stores '6. Fuel Suppliers ADDRESS Q 13 1 (;lass: i 7.Miscellaneous W<,QUANTITIES AND STORAGE (IN= indoors;OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) x new motor oil (C) transmissi .dr is Synthetic Organics: degreasers J Miscellaneous: Y_ v rk l_-�5 I L `7 ) DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply _ ,b� _ S O Town Sewer 30ublic ) XOn-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC FA4S�S G^- O Catch basin/Dry well ` O On-site system -q ckhe 4. Outdoor Surface drains:YES NO, O Holding tank:MDC O Catch basin/Dry well O On-site system 2 a-Q]Lg-qw� RG6 5.Waste Transporter Name of Hauler Destination Waste Product Licensed? NO 1- Wycr� o cA L Nnc\v-,\c�o , �o --A--�as Vj + 2. Alfn I C_ Persor:((s) I erviewed Ins ector Date A�. p 0 TOWN OF BARNSTABLE COMPLIANCE: CL S: 1.Marine,Gas Stations,Rep 'r satisfactory 2.Printers BOARD OF L E H - 3.Auto Body Shops y� oW/� l�j� O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores '! 6.Fuel Suppliers ADDRESS / ff0 fFr l�� Class: �1 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR AFATERULS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test F�els- Gasoline, a Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers C� ell eous: 1 f c. J � 1 F. DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer , 'ublic 42 On-site OPrivate m , 3:Indoor Floor Drains YES N0 Holding tank:MDC O Catch basin/Dry well O On-site system 4. 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Pra`;: t 'FL 'fix , f •diy ' [ ".� r „. t 4 t --- ¢ 4I R ,..r� 4 n 4 x �'. iv '"v',iw o S!'�' t 3 x' ,+ c a s +nr c ::^s k '::L� c 1.^� o?,t..;, tr s7 yr- .;i„ i' r "s4, _.' %.Ir 6 N` 4,3, 7 s .. ;R try ,X'j 7 „ti ., .HyaLenas,;,-Mai, x =r �L , r ! r'r l I-x +x'�r Y f- S Y bt l Y. R y,'.P#'t, .,��' 4a i"`,.' a t ..fit . k A a t .r-'+ ` y, t•. S :'. v<,4 x`,E:• ,, «'yy. .} 4M1 ,, a S X �+ y. ., t k -- w fi r` . sS' is `t ` .. I ,a„s J .-. , 6 ; " .,,I CB rFTO ABATE VIOLATIONS OF.THEE+TOWN,dF."BARNSTABDE`'TOX2C .AND =' �. ".>' ,f +h` Y�YHAZARDOUS WASTE BY. LAW },k 7 r y , ' , ,x rr vJ V. ' r r t S -'t .• v 4% "y a, e` 1�^..'.t tS i �ttS .�y+r + 3 6, d r''' 45 F�.it ,�'i F4 . , ',•yc L•+ .V 5, v" e , -., { toy r +R ," '°u . `� The propertyr own�'d*by. your`at .Iya�nough',;Hil, s Gb1 Club wa`s.inspected `t t� ; �sx f one Apri"1' 0. �98 ' tf, )*.,. ,hn,;,Jac�ibi H�a1th���Ins eCtor �foz•`-the Town:of 4 i '4' 4 h b M _ e y r X$arnstab e, Thy fo .Mowing �vi.cala . qns tare o served; :', ,¢:� l' i4 ��'tt' '-*1 ',', :�r 4w„' e [ ,+ " 7,., J-. at ',M' �r i. t g.;�R.ff " yfz, ..'^# 6 t,a ,t a ! ' ,,1. a... n 7 F }7, 4 , . '. 1. .1.4W ,•� 6. J`,' d .r,`' p i - `' ..§y. 4 t ,. SECT (JN 4 `;(A) I1 Waste roil dischargedl onto the ground both inside' �' R F=the a�Ctaintennce e , ,. k Sir ti ' , 11 ,,4 gar cyi1f d-in#.the xyear area` 4the < gage `b t :a e ..L+, t rI ; �„ y v ..�� . v kN �'S tY '4 ee a of .F - % - ;, { R FgrC.t..+,tr+ ;� ,t,,, - , r.fi.J ysn� „ett 7 K 1, x n r A , •fa _ ,, 6. kk � � =�,•y`' Z �' o 'ti ", 16 G w, �7�iL.TJ.VFr �! '�.t i7) i ~Va t P '} '4 r + „ �a l . : �. J ♦t, r�Ge garage in t a- spline stored outsa de of ' vantena , .t+" ` ; , n unmarked. 55 Yga1 ii.,drum 4` not pr itected `aga�ni t 'the 161ements. ' `: . ';'k J.%! 1+`, r' - �. a 'i Ik v y' Y`1y.5 - �.�`s r. A ry.4+1k�"°f i..* ,t.` :P r .t � a. - .. 91, �� r >° �tSECTION �. <�A) :"y Fdktijj�zera.�` rf` e=es ad �25�'pauhds, dr�r we' ht ; t stored wit out: reg strateioii from-t i6-- Board Qf Health. ` -2 ; y, BB6. > Li d. t'�. '♦ R 'y xi.I '+ .+ i .:f r• k ;� uW., f' {? r , Ie vd+,i' "e F v• d 1;. y' L 'a`. f, " [ t a i a t $ act. } $,' } SECTION ri f ,.�. t ,r< „ .= ., 5. t8) �V, No ;prI .6 Ztight cdntainers,providedy for, waste I > ,'`` o f ,.or bags band bottles of etc .d s. M� ;, r, ` �q .S1 t `4t Tr{ � .5 Y + _ r .-,x s,.. 4 r k u%i., I }!. °1 .,i .v z S, s_r ,f^ ., y .'„. Rrl f L- ? _, K ,' x .0 t' y. y f. t 'f. •r4 Y .f +; j. r % " 4' You area dzfec'ted to per to t i;c R ,waste z provide oduc ytigh 'antainers fo= all ,:�';csilik and;<.p®st ' es, within rten t lt?) ,days of .rece�.pt .of this order: "F' ,^r. ,� Whey";must=, be -stored=;ins�.de,r„cuff th1.e aground.;,. protected ,from the e],ements. R" y+ Ott r. 'fir.'# �: 3p, i:° f t �' _ ° e;f s.' Y �. [ Sx.. ."-4 . ' s t'f"'`" �.s K. 'Gasoline `had Cl A µ1 ,b '`a ; tr f t r" t co c c # x5. a in lanmab es i�us a .sto ed in,:s r t rc7ance 5' - '�w .th local fire C6 esS `In Additiax? ' out must,tfurni�sh'us a:,complete {' .-:� t� .nv ntory�i f a . Tes ti'd es ..,am ext li zers :i thin`= t : . .(10) c�a s o `s �� r ��rTnetcse�fp��ly� f� thi s h order Viand, thearea�7ftar �sem--'ainnua�.ly� on A0,rC-i and x.%� A , i+ti .•i * `,LYVY�++rMr'rw.k J,=.i��r " �`I �bta r rh ,.,a Y' *' ice} yt,...�kf,t+ �,� `rt S r ti+ ��_ r r'Z4 �A7 ' '{y7 t.� < ;,(_ .c 7 y r t a ? r` ,t is ° .4 r ft. 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"% `'�r ,rr r� r�„ '+,., ... 11�1 § -,,' y •f' a •is§i r?x.[r to F+i + < •Ire 7 ,,;`J R r { r s r h 'a x'4wy� i� {sue `tl " L ,r k�. r *-'+b+ '" �. 4 •y t+- Ye, •,1_' 4 _.4 ti' t _� + jk' r Fr k i r sir+ "'.'_Y�„u>K! ` } ,J.: Y ,� r fi F w, S - r e 1y t, S� ,k Aa{ w, #,,Jy ,,t +f'�.. a - ce !' - fa ` . •r S t'Lt t .;^. i 11 ,J,. 4`tt,' r+`'7}�'R' T ` aC. 4°,.� �. 1 � ..k 4 ,..f ,y` c R b P L f „ f Y. F it IN i A •. , ,,r. f t a. . '" r1 to "tys..�. JAB'pe(i, .` ,4� I / t x R i' ;'4 � �• _ y t, .x-,, f d ant„ :,I I+s 'h,a % t? /Jt".4/••1 r sl i:. • R: (F t i 4 ?, y` y _ " �Y. G'.. Nil.'Z,11�i",*,-.��,4.. i r] J' ,ry�{f €r " E .x t' ,y L •� �tr,I ti . tit TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Gilrint3 Goir �(�L Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: "L own of Barnstable TELEPHONE NUMBER: %Z 2-&0 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 qu cities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES O 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 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 L 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 V.- 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, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy Business 0. TOWN OF BARNSTABLE OMPLIWCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY %� i s G�do���G O (see"Orders") 5.Retail Stores �� 6.Fuel Suppliers ADDRESS ��` ZklZd w'f Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: ( � �� v Gasoline J v Diesel, Keyer Heavy Oils: Ak waste motor oil (C) new motor oil(C) A9�G5 tPftRsmissinu/hydrauhc Synthetic Organics: AqZr easers 5' U Miscellaneous: gta i7a3 41YLM/ DISPOSAIJRECLAMATIO REMARKS: 1149 1. Sanitary Sewage 2. E r upply S � O Town Sewer ublic ;1k. '�On-site ��� ��QYIy Private 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: ` O Holding tank:MDC O Catch basin/Dry well O On-site system S - 5. Waste Transporter Name of Hauler Destination Waste Product Licensed? 1. •�/L /" i%�/ lox NO 2. 12 Person ( ) terviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM ,f/� Mail To: NAME OF BUSINESS: AAA and of Health MAILING ADDRESS: Z—V� 4WdL2 ,SAY Town of Barnstable TELEPHONE NUMBER: <;r" . P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quanti es 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 " 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 (iQc, 4udit Pa#e41aidj Disinfectants Motor oils/waste oils Road Salt (Halite) P1 Gasoline, JeWp& Refrigerants Diesel fuel, krrT, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) IAL Degreasers for engines and metal A- 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 t/ Paints, u isf�s, stains Fertilizers (if stored outdoors) 4 Paint & lecgaerthinners 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) Z/ Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business .. . -m TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY se, (see"Orders") 5.Retail Stores 6.Fuel Suppliers. ADDRESS Class• 7.Miscellaneous QUANTI IES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: l P Tod Fri 1 /^� Gasoline, �. W, 1 Diesel, Item, #2 (B) Heavy Oils: waste motor of (C) new motor oil(C) ! � Synthetic Organics: degreasers le-b l/ Miscellaneous: r l 0/9 dz 001 ss L l - DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic 011On-site (Vrivate c. 01 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system P 4. Outdoor Surface drains:YES N0_1/ O DE ._ O Holding tank: MDC O Catch basin/Dry well G �, O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. a n Pe son s) Interviewed �._____ Inspector 4Date . 3o �_ -- THE COMMONWEALTH OF MASSACHUSETTS 0"/A r7 � "v'4- "A.�7-Il d/e'' BOARD OF HEALTH NOTICE TO ABATE A NUISANCE Asittoa t of IYA",,9d I'//- Z5 you are hereby notified to remedy the conditions named below within 24 hours of the service of this notice, according to Massachusetts General Laws, Chapter III, Section 123: 17 WX 72-:- gy/Z - G Q h r 4SO A s S ILL A/ 1A,17� If at the expkrjtion of time allowed-these conditions have not been remedied, such further action will be taken as the law requires and a fine of$20.00 per day may be charged. By Order of the Board of Health Inspector FORM 600 HOBBS&WARREN,INC. REVISED 1979 / � N OF BA R N STA B L E COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair O satisfactory 2. Printers { O A R D OF HEALTH 3. Auto Body Shops r► '��' (),unsatisfactory- 4. Manufacturers (see"Orders") S. Retail Stores 6. Fuel Suppliers LESS , Cla.ss: 7. Miscellaneous —LK I QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) R MATERIALS Case lots Drums AbOveTanks Undetgrouad Tanks IN IOUT 11N IOUT IINIOUT # & L7allonse 'rest? els: Gasoline, Jet Fuel (A) U��'�e �/•� Diesel, Kerosene, #2 (B) :avy Oils: waste motor oil (C) new motor oil (C) 3 /JV transmission/hydraulic ,nthetic Organics:" , degreasers Jr vR,a4 ? - 4- 1 scellaneous: y OSAL RECLAMATION &REMARKS: Sanitary Sewage 2. Water Supply OTown Sewer 0 On-site A/o�� c 0O Public Private I Indoor Floor Drains: YES2 N0 _ Holding tank: MDC _ n 'fin�- 1 ✓i V/ v L i�• Catch basin/Dry well O J , 0 On-site system / Outdoor Surface drains-.YES NC ' � � ® Holding tank: MDC - �Y . 0 Catch basin/Dry well j � � - 40 Z�-_- x " OOn-site system Waste Transporter p 4(eV14�_ 6zAITII"6417_1 4 w,ST� 44 icensed? NaaMe of Hauler. Destina ion .0� ast`�SP' /du 6/1004/ 81 Person(s) Int.erviewed �;` 7 � Inspector Wae TOWN O F BA R N STA B L E COMPLIANCE: GLASS: 1. Marine,Gas Stations,Repai.r satisfactory ' 2:- Printers a BOARD OF HEALTH 3. Auto Body Shops Q unsatisfactory- 4. Manufacturers COMPANY (see"Orders") 5. Retail Stores --- - 6. Fuel Suppliers ADDRESS (�, Class: ! 7. Miscellaneous - QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums , AboveTanks Undetground Tanks fIN OUT IIN IOUT IN UT #* & gallons Age rest? Fuels: Gasoline, Jet Fuel (A) FT U,�l,(`,�/6 Diesel, Kerosene, #2 (B) Heavy Oils: t waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers J��,a A A;,,Z' 1 2 T__ Miscellaneous: Itt, >.,-, /-ir1�S L 110111/1 111) filA DISPOSAL RECLAMATION MARKS: 1. Sanitary Sewage 2, Water Supply 0 Town Sewer �O Public ffgd ® On-site k00 O Private oz f 3. Indoor Floor Drains: YESZ NO _ ,4 1 _ -c ® Holding tank: MDC , Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES B /NC V Holding tank: MDC •/D. � y -`�}-�:� - ® Catch basin/Dry well .•_ • _ On-site system44 .— S. Waste Transporter p Ok icensed? Name o f Hauer. Des na ,on g� 9T 3J`o ( .5 /3P' F G�'oaU 1. 23 81 Person(s) Int.erviewed '. Inspector Date i April 14, 1982 Mr. Allan Jones Iyanough Hills Golf Club ' Route 132 Hyannis, Ma. NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE TOXIC AND HAZARDOUS WASTE BY LAW The property owned by you at Iyanough Hills Golf Club wa's inspected on April 12, 1982, by John Jacobi, Health Inspector for the Town of Barnstable. The following violations were observed: SECTION 3 (A) : Waste oil discharged onto the ground both inside the maintenance garage and in the rear area of the garage. SECTION 4 (B) : Gasoline stored outside of maintenance garage in Dan unmarked 55 gallon drum - not protected against the elements. SECTION 5 (A) : Fertilizers in excess of 25 pounds, dry weight, stored without registration from the Board of Health. SECTION 5 (B) : No product tight containers provided for waste oil or bags and bottles of pesticides. i You are directed to provide product tight containers for all waste oils and pesticides within ten (10) days of receipt of this order, They must be stored inside, off the ground, protected from the elements. Gasoline and Class A inflammables must be stored in strict accordance with local fire codes, In addition, you must furnish us a complete inventory of all pesticides, and fertilizers within ten (10) days of receipt of this order and thereafter semi-annually on April I and November 1. ' 1 Mr. Allan Jones Iyanough Hills Golf Club Page 2 April 14, 1982 You may request a hearing before the Board of Health if written pe- tition requesting same is received seven (7) days after the date order served. Non-compliance could result in a fine of .up to $200. Each days .failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH John M. Kelly Director of Public Health JMK/mm cc: Mr. Thomas Mullen Chief Richard Farenkopf �►-OWN OF BARNSTABL� COMPLIANCE: CLASS: 1. Marine,Gas� Stations,REpai.r Q satisfactory •€{Pr.inters -_ BOA _D) OF HEALTH 3. . Auto Body Shops unsatisfactory- 4. Manufacturers c II R. (see"Orders") 5. Retail. Stores COMPANY 11 : 6. Fuel Suppliers ADDRESS i 5 - )-�. ..A �_� Class: 7. Miscellaneous — � D STORAGE (IN=indoors; OUT=outdoors; QUANTITIES AN MAJOR MATERIALS Case lots Drums AboveTanks Underground Tank IN UT IN 0 IN UT zl e - Fuels: Gasoline, Jet Fuel (A) Diesei, Kerosene, #2' (B) Heavy Oils: waste motor oil (C) new motor oil / . transmissi /hydrauli Synthetic Organics: _�.egreasers . AP rt 1.J� DISPOSAL RECLATION REW,RKS:MA 1. Sanitary Sewage 2. Water Supply - ' 4 -" C),Town Sewer O Public oOn-site ., Private ( - 3. ,Indoor Floor Drains: YES?, .No 0 Holding tank:�MDC ', . r _ (),'Catch basin/Dry well - ----- ----- ----.�..-- ------ — OOn-site system J `� 4. Outdoor Surface drains:YES. : NC _ '`' . ` - Hol'din tank: MDC O,Catch basin/Dry well UA A , On-site system S. Waste Transporter 2-�j M. - Licensed? Name f. Hauler Destination } aSte Product- ' lX Person(s) Int.erview�d jI spector Date J ' TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: - BAXTER TRANSPORT, INC. MAILING ADDRESS: DRAWER W. HYANNIS, MASS. 02601 TELEPHONE NUMBER: 775_0232 CONTACT PERSON: RONALD DESOUZA 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 je`* 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 : // I ll ADDRESS: Z U cl f'120.� TyAviogj� j4i l$ �(r C/uJ TELEPHONE:- - - LIST OF TOXIC AND HAZARDOUS MATERIALS The .Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems ) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides ) Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine lubricants Lye -or caustic soda Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) _ Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar carbons , (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers Paint brush cleaners 'Poison" labels (including chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach ) which you feel may be Spot removers & cleaning fluidsR E C E UV E ® toxic or hazardous (please (dry cleaners ) HEALTH DEPT. list) Other cleaning solvents ,TOWN OF BARNSTABLE Bug and tar removers Household cleansers, oven cleaners Drain cleaners z� Toilet cleaners Cesspool cleaners JUN 1 g 1981 . Disinfectants Road Salt (Halite) TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM ADDRESS Major types of materials: 1) 2) 3) 4) 5) .6) I. Description of materials) use: II. Storage (denote product by number listed above). A. Containers metal/ glass. paper plastic cans,bottles,"jars �r5 drums,barrels r ct, . Owl- aboveground tanks ` Z.. - underground tanks bags,boxes open,loose,uncovered inadequate labelling = B. Storage-Facility Vor:# Remarks/Recommendations 1. Indoor - - a) separate, contained room b) .stored in general work area i) inadequate ventilation _ ii) floor drains* iii) inadequate fire protection 2. Outdoor _ a) uncovered, exposed to weather ,_ b) pervious 'surface/catch basins - III. Disposal A. Reclamation/Recycling unit B. On-site disposal _ 1. Town. sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler b) address or disposal site Person(s) Interviewed = T _ — — _ — Inspectori _ — -/- — — _ — — _ — — Date