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HomeMy WebLinkAbout0052 THORNTON DRIVE - Health 52 Th., rnton_Dr._,3Barnst_able a Ron's Ty f , R r I �I a i Town of Barnstable �FTME r Regulatory Services yP� ~� Thomas F. Geiler,Director Public Health Division * BARNSTABLE, * Thomas McKean,Director y MASS. g 200 Main Street, Hyannis,MA 02601 1 39. prFD MAC A Phone: 508-862-4644 Email: health(a,town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00 5:00 November 7, 2006 0 Ron Pacheco Ron's Truck Stop 52 Thornton Drive Hyannis, MA 02601 Dear Mr. Pacheco: Thank you for your time and cooperation during the hazardous materials inventory and site visit at Ron's Truck Stop on September 26, 2006. This letter contains information from that visit that will help you become compliant with Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials. Enclosed are copies of Chapter 108: Hazardous Materials ordinance, and a copy of the Toxic and Hazardous Materials On-Site Inventory form from the visit to your business. Please note the problems identified at your place of business during the hazardous materials inspection and their corresponding recommendations listed below: PROBLEM: • There was petroleum observed around the base of the new oil tank. ORDER: • Section 5 (B) of Code 108 states, "Provisions shall be made to contain the product(i.e. hazardous materials) in the case of an accidental release." • Place absorbent pads on the top of the tank so they can absorb any small releases or spills and keep it from running down the tank to the ground. • Clean up the speedy dry that is on the release as soon as the absorption is complete. PROBLEM: • The waste antifreeze drums were not properly labeled. ORDER: • Please label the drums with"Waste Antifreeze". Ask the waste hauler for the label if possible. On Site Inventory Total The Toxic and Hazardous Materials On-Site Inventory from September 26,2006 shows that you have approximately 917 gallons of toxic and hazardous materials being used, stored, generated and disposed of at the Ron's Truck Stop, 52 Thornton Drive,Hyannis (Please see enclosed Toxic and Hazardous Materials On Site Inventory sheet). The Board of Health has determined that the using, storing, generating and disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. This license has been obtained for the fiscal year 2006- 2007. If you have any questions about these problems,the orders and recommendations, or you need further information, guidance or assistance,please do not hesitate to contact the Public Health Division. Sincerely, Alisha L. Parker Hazardous Materials Specialist I All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials shall be co pleted upon receipt of this letter. omas A. McKean, RS, Cl Director of Public Health Enc. On-Site Inventory(copy) Chapter 108 (copy) i i Town of Barnstable vaFzME� ti Regulatory Services Thomas F. Geiler,Director ✓p 9L Public Health Division �� MA'33.. -1439 ♦0 ; '°FEn rctAy° Thomas McKean,Director �Ir� s 200 Main Street,-Hyannis, MA 02601 I l� Office: 508-862-4644 Fax:.508-790-6304 . Application Fee: $100.00 w �. ASSESSORS MAP AND PARCEL NO.!aj M D DATE APPI.4ICATI$0N FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT r-�(?)w)S TV_U cV_ 0Tn l yc ADDRESS OF ESTABLISHMENT �` b 4y Ak 1 v TELEPHONE NUMBER SOLE OWNER SO t •� L'vr i rY t4 h a s'+rr k, c [ + ''sd IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: V IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 04aT D STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT Palo WIV F(0l•WIC1U TREASURER Clk`M PA-kNFLO t. i, 02S CLERK { r r, IGNATURE OF APPLICANT' p RESTRICTIONS: HOME ADDRESS r. HOME TELEPHONE# Haz.doclwplq MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed.application form. Also, please fax copies of your employees'food sanitation training certificates. In addition, you must mail the required fee amou nt unt (see fees-at bottom of thispage). Plea se make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in- house processing. . For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page n Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Ron's Truck Stop 52 Thornton Dr., 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 June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 24, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health T453ed6ate: 9 /1 / Ali TOWN OF BARNSTABLE y�S� fp� TOXIC AND HAZARDOUS MATERIALS ON-SA!5 INVCGENTORY NAME OF BUSINESS: po� uk Aw BUSINESS LOCATION: ���n I rvt, ` INVENTORY MAILING ADDRESS: r� io TOTAL AMOUNT: TELEPHONE NUMBER: --7 1 — ,64q 7f f CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFO MATION/RECOMMEND ,TIONS: A Fire us ict: -Po (1Z Pff - I. V-K '° I,()tt,S'fi fit-fi`, �n �� �� till—, Waste Transportation: Last shipment of hazardous waste: Name of Hauler• Destination- Waste Product: Licensed<. Yes,�N No 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. 9 P 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) Misc. 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 15-6' NEW N5_USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED ® Misc. petroleum products: grease, Photochemicals (Developer) i 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 Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Fiammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): 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 I nRl lWrum/L b�a- - k M- fra m OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE 5 er:2 ANITFREEZE 1�® 2 r,-02- x,7— 0 I\fb GASOLINE WASTE GAS DIESEL FUEL W ' ,FLUID GATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE MABLE CORROSIVE PETROLEUM gX G� GJ (GEAR OIL/GREASE/ LUBRICANTS) 8 �o DO FREON ACETYLENE CAR WASH C_ PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID O ` FERTALIZERS B�AST/E SOLVENT MSDS l� v MANIFESTS Cj_K tk) did v, r ood ed � o La m* t'D a bWbl(-d, P-kt facdo oit.fi,P t Pf.o-fo) � � o t ch"V�k Town of Barnstable z� Regulatory Services Thomas F. Geiler,DirectorBAMSM V 9�A . g Public Health Division / 10, renMa�°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 NO. "02 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT � 'A1 c� SOLE OWNER: "S NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OFZA L 00 PARTNERS: o -0 N rn IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 04 D--n 939-1 STATROF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT,- 00-ou, "1 REASURER nCkLW CLERK 4 SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS— HOME,TELEPHONE# � � Hn.dodwp/q r, Date: / Z I /6c/ TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENT O Y NAME OF BUSINESS: �o BUSINESS LOCATION 52 INVENTO Y l2B MAILING ADDRESS: TOTAL AM NT- TELEPHONE NUMBER: '5n S o -7-7 —' 544 7 CONTACT PERSON: R e EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF'BUSINESS: ��� y INFORMATION/RECOMMENDATIONS: Prey- -RAAIZ'I CLAA Fire District: �Q�-►OV��trLt/�- 1rYl a�P/LiGt��ct�-� (°�o-n�-Gt.�i'7 P.r'3 °°'�'oX/C.-°j Grs-r.�w1 Waste Transportation: �- Last shipment of hazardous.waste: Name of Hduler: Ctu a poll Destination• Waste P o;duct: A-1= az t Licensed? Yes No 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,OFTOXIC 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) Misc. Corrosive r �oU NEW t- S E D Cesspool cleaners Z .... �°utomatic tran�on fluid Disinfectants A Engine.and radiator flushes Road Salts (Halite)+ Hydraulic fluid (including brake fluid) Refrigerants I .Motor Oils Pesticides 3 NEW 2--75USED (insecticides, herbicides, rodenticides) CLA Gine Jet fuel`Aviation as Photochemicals (Fixers) , .Diesel Fuel, kerosene, #2 heating oil NEW USED �y Misc. petroleum products: grease, Photochemicals (Developer) <f lubricants, gear oil' NEW USED Degreasers.for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) t Caulk/Grout Swimming pool chlorine 0, Battery acid;(electrolyte)/Batterie Lye or caustic soda Rustproofe.rs Misc. Combustible ,> Car wash°detergents . Leather dyes ..Car,waxes and polishes Fertilizers ' ri; a b Asphalt & ro"offing tar PCB's + ? Paints, varnishes,�:,stains, dyes , Other chlorinated hydrocarbons, r . ' {Lacquer thinners (inc. carbon tetrachloride) NfW ' USED Any other products with "poison" labels Paint`&varnish removers, deglossers (including chloroform, formaldehyde, M sc Flammables, hydrochloric acid, other acids) Floor.&furniture strippers Other products not listed which you feel efb'I,; olish;es may be toxic or hazardous (please list): p , Laundry soil & stain removers £, (including bleach) Spot removers &cleaning fluids 4 ' (dry cleaners) vlv Other cleaning solvents OL -.Bug and tar removers O Wir'dsh.ieId wash ' WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town of Barnstable �tM Regulatory Services c� Thomas F. Geiler,Director • Y 's'& Public Health Division � rEo � Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND.PARCEL NO. � DATE D ' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT £ r') A5. � s TELEPHONE NUMBER r ".�.vaj,.A.}.'W.i:..t`_'�..+. ..... - 4�� c� �� SOLE OWNER '✓ YES -NO ,_ �, Z�7s`z_ aar?�ti, ,��� IF�APPLICANT IS A=PARTNERSHIP;FULL NAME.AND HOME'-ADDRESS,O_F ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0 STATE OF INCORPORATION AA FULL NAME AND HOME ADDRESS PRESIDENT B. l A RD E RLWAYM 025'rm i TREASURER i ` CLERK �` k Vv SIGNATURE OVAPPLICANT RESTRICTIONS: HOME ADDRESS • ,:_ HOME TELEPHONE# ;., Haz.doc/wp/q C MAIL-IN REQUESTS • cn Please mail the completed application form to the address below. Also include aqtmpy of amour contingency plan(to handle hazardous waste spills, etc). In addition, please include the required' cn of$100. Make check payable to: Town of Barnstable. Allow five to seven (7)workin days fWin- m house processing. Our mailing address is: r10 rrn Town of Barnstable Public Health Division 200 Main Street _M Hyannis,-MA•02601, FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous wastespills, etc). In addition, please mail the required fee amount of$100.00..' Please make the check:payable to: Town of Barnstable. The check must be mailed to the address listed above.;Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS _.. DBA: Ron's Truck Stop Fax: (. — Corp Name: Mailing Address �1 _ .. ...... ....... .. Location: 52 Thornton Dr.,Barnstable Street: 52 Thornton Dr. mappar: City: mya hft 19�C5- Contact: :Ron or Cathy State: Ma Telephone: (508)771-5497 Zip: 0.2w. v2&3a Emergency: Person Interviewed: .... ........ Business Contact Letter Date: j 17/O Category: Miscellaneous Inventory Site Visit Date: O Type: Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains ❑ outdoor surface drains Q license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed W town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin)drywell expir - - ❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: ...............__............................... ...... Remarks: MSDS&Manifests on site. Outside double walled heating compliance: oil tank. Antifreeze recycled with Tirrell Radiator. Batteries recycled Satisfactory with Interstate. Water based pressure washer(PMW). Safety Kleen . brake washing unit. Oil filters drained-dumpster. No Freon work- shall start summer 96. Shall start Antifreeze recycling. Remarks: ,/9 4/3/97 Antifreeze recycling,freon recovery,sped!-dry for spills. Note: See 97 inspection report for current list of toxic&haz.Chemicals on G3 u site. G REMARKS: MV5087715497. Speedy dry on-site for surgace spills. Interstate takes batteries. Unifirst does rags and Uniforms. Oil filters. y � g r °�v � �. - c.,al•lei ��� - �iL z7 q ll � l :� y i e. P-2Z.-J .,z 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 rrieasure .. . antifreeze(for gasoline or coolant systems) 8 Cases _. ..__._. ._ .... ._.. _....__...�.....___ _ _. .........._.m.._.. . _ _. m _ _ __ ........ ..._.._. waste antifreeze 20:Gallons misc.petroleum products:grease,lubricants 90Pounds automatic transmission fluid 3Cases hydraulic fluids(including break fluid) 30 Gallons diesel fuel,kerosene,#2 heating oil 500;Gallons motor oil _ 150'Gallons aste oil 200Gallons Waste Transporter: Cyn Oil Fire District: Last HW Shipment Date. Waste Hauler Licensed: Yes Date: 6' / 21 /b`/ TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: (3oxi 15 `��' BUSINESS LOCATION:— D-1. /-64a INVENTORY MAILING ADDRESS: �� TOTAL AMOUNT: TELEPHONE NUMBER: 5n 2 v —7-7/ -" 5-4/ 017 E3° p is CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: �� n - �&I- INFORMATION/RECOMMENDATIONS: Fire District: Gt/�D�crLvJ- 4/Yl a ?/LiG °� "eras Le.- c� ;P7 4i - a ex 4- Waste Transportation: mil - Last shipment of hazardous,waste: Name of Hauler: Cu 11 0'1 Destination Waste Product: = . aiC Licensed? Yes No 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. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive �gNEW y SED Cesspool cleaners Z Automatic atic trans�on fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides 3aQ NEW Z-7S�ED (insecticides, herbicides, rodenticides) G soline Jet fuel-Aviation as Photochemicals Fixers g ( ) Diesel Fuel, 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 —70 Battery acid (electrolyte)/Batteries, Lye or caustic soda Rustproofers Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor & furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry Soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers v(� Oz 1.4 Windshield wash Cy WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS a { TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Re r satisfactory 2•Printers BOARD OF HEALTH 3.Auto Body Shops �.r O unsatisfactory- 4.Manufacturers COMPANY f,✓44 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS.,,)"', ' Z IJL� " Class: 7.Miscellaneous 64KS- A QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) ,MAJOR MATERIALS IN OUT IN OUTI IN OUT #&gallons Age Test Fuels: G soline,Jet F el (A) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic �' } Synthetic Organics: degreasers Miscell ne us:,, ,3`1 �� ®= 9, DISPOSAIJRECI.AMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 4 - *Town Sewer 'ublic O On-site OPrivate , 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well 1 O On-site system 5.Waste Transporter Name of Hauler ' D 2. Person(s) Interviewed Inspector Date' • • i ' ' ' i 0 satisfactory 2.Printers , ►�► .• K— E unsatisfactory- 4.Manufacturers "Orders") 5.Retail Stores Fuel Suppliers row 1 �� •Case lots, Drums Above Tanks (Underground Tanks IMMENSE W.Mgmallaps OEM ENEEMEM, SEMEN • • f t 1 �i/ • (I • �i+J/vim�� �� ��`�/ � /.�/i��/.i�/ • • • 1 L//�, .:' _.._ .._ ��� ,i ��- .� r . .ice i, • •. 1 I Name of Hauler Destination Waste Product j Licensed? TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH P" satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY S ��� T, (see"Orders") 5.Retail Stores yU� 6.Fuel Suppliers ADDRESS ��Z a-rC4441 rG;,J Class' 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALSUnderground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) `'&W 01n rtn- Heavy Oils: ��r waste motor oil (C) Z LS 11Z� new motor oil (C) transmission/hydraulic j/ i Synthetic Organics: degreasers � - sy Miscellaneous: s A4f u 6v. s � 4 eqk DISPOSAI.lREt;LAMATION REMARKS: 1 Sanitary Sewage 2. Water Supply v5Z s�9 7� S c"-iik (L�-Ju cz Town Sewer Wublic i.x1 > J—t" J-I off. I , 'j �g Ui•r �SdL O On-site OPrivate 3. Indoor Floor Drains YES--NO-4— O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO X ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product / YES NO e a � Z� Person(s) Interviewed Inspe for Date FF DBA Name Location Notes Chem/large amt. Date Compliance Business Category Ron's Truck Stop Remarks: MSDS&Manifests on site. Yes 12/18/95 Satisfactory Miscellaneous 52 Thornton Dr.,Barnstable Outside double walled heating oil 4/3/97 Hyannis tank. Antifreeze recycled with Tirrell Radiator. Batteries recycled with Interstate. Water based pressure washer(PMW). Safety Kleen brake washing unit. Oil filters drained- dumpster. No Freon work-shall start summer 96. Shall start Antifreeze recycling. Remarks: 4/3/97 Antifreeze recycling,freon recovery, spedi-dry for spills. Note: See 97 inspection report for current list of tonic&haz. chemicals on site. Ross Jewelers Orders: 6/23/97 MSDS sheets. No 6/23/97 Satisfactory Retail Store Iyanough Rd. C.C.Mall,Hyannis Hyannis Rotary Auto Body Remarks: Closed system spray booth. Yes 12/29/95 Satisfactory Vehicle Maintenance 345 Barnstable Road,Hyannis No freon work. Shall transfer two 6/10/97 Hyannis outside above ground tanks to inside. Remarks: 6/10/97 Spray Booth,MSDS sheets. Note: See 97 inspection report for current list of chem. on site. Rufleth,Peter W.,M.D. No incomplete Medical Care Ficlty. 6 Main Street,Hyannis Hyannis Rusty's T.V. Note: 5/30/97 No toxic or haz. mat. on No 5/30/97 not required Appliance Repair 146 Thornton Drive,Barnstable site. Hyannis Ryll's Auto Refinish&Restora Minimal cleaning products on sit. Yes 12/15/94 Unsatisfactory Vehicle Maintenance 381 Old Falmouth Rd.,#14 Mar Uses Landfill for personal waste oil. Marston Mills Spray booth in place. Inspected by fire- fresh supplied air system change filters at 2 mos. Trash paints/Laquer thinner in cabinets. *********Mst have MSDS sheets on sitein designated area. Ryll's Automotive Collision Remarks: 10/23/95,Used antifreeze) Yes 10/23/95 Satisfactory Vehicle Maintenance 381 Old Falmouth Rd.,Marston back to supplier. Used Speedy Dri for 50-'-J 3/21/96 Marstons Mills oil spills. Paint products stored in 3/25/96 metal cabinets. Has Fire Dept. Cert. for paint. E.P. A. MA502428873 9. Orders: Recycle Speedy Dri. Remarks: 3/25/96 Auto body repair. Have Laundry services. Have paint booth. Have E.P.A. number. S.B.Landscaping&Tree Servi ****ALSO,INSIDE,ABOVE Yes Unsatisfactory Landscapers 92 Rosary Lane,Unit 14,Hyanni GROUND 275 GALLON Hyannis TANK*****DZM 5/18/95. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair �J BOARD OF HEALTH satisfactory 2.Printers ' 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY I -T—i , S % (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS,tea v�oa; = .Class: 7.Miscellaneous rrS� QUANTIFIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS ,• _ IN OUT I IN I OUTI IN OUT #&gallons 777 Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: j- waste motor oil (C) gc-au- new motor oil (C) 1 d a transmissioq drauli S�ry Synthetic Organics: degreasers Miscellaneous: �3 y 9 s" DISPOSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply rep XTown Sewer OPublic O On-site OPrivate S S V 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 5.Waste Transporter Name of Hauler 1 ' o uct YES NO 2. lat I/ t ®e9 Person (s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: Board of Health BUSINESS LOCATION: V= ` MAILING ADDRESS: S °� 0. own of Barnstable P.O. Box 534 .TELEPHONE NUMBER: ED `71 1 SZ49-7 Hyannis, MA 02601 CONTACT PERSON: 4 f/y o-DdAJ tEMERGENCY CONTACT TELEPHONE NUMB R: 1trjrorcA1 v Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, '1§1 - 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 vAntifreeze (for gasoline or coolant systems) Drain cleaners 3QQ_1�6 Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners . Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils a601TO Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, 30cQ*L� 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, 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 t Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business I .. .. ry- 4.Manufacturers • ' ' r� L �� , • "Orders") 6.Fuel Suppliers 7.Miscellaneous 0 off Case lots Drums Above Tanks I Underground Tanks'. SENSE N�Mll _®�_®�_®�ifiiiWiii•im� in ARM 1 1 a it waste m --i soon OEM otor 1 t;,It ions MENEEMEM ON mill�It4i, 19491?MV -all • . 1 119,01 FAD , - .. 1,� _�. . JA MMMIN 0 off • • NO Name of Hauler Destination Waste Product Licensed? LOCATION SEWAGE PERMIT NO• VILLAGE INS. 2A LLER'S NAME i ADDRESS �- r - BUILDER OR OWNER 1,57 DATE PERMIT ISSUED r� r DATE COMPLIANCE ISSUED 1 C -" e qD , Lat35�- LOCATION �7- SEWAGE PERMIT NO. oAlc VILLAGE Jul /6� INS. A LLER'S NAME & ADDRESS " BUILDER OR OWNER P SAL 1/l� DATE PERMIT ISSUED �r DATE COMPLIANCE ISSUEDz6 _�� r 40� .39 lQ�C}9 ,r a I —C- P-tr ,1 LOON SEWAGE PE RIYI N0. ,< V I V L A G E -- IN.STA LLER'S NAME & ESS ".O/?.�P's /�y/'"lire''"'✓' u B U I'L D E R OR OWNER a Rio"Y'/� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r '� �it�9 � --- v G: f�I � /'\ �4�T✓.� GX%�'��'s.a,. e No....................... 4 Finc.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .1.._.._.....OF..'?... ..I—...! ��g h--k,..........................:.......... Applirution for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: To Loc flu Address or N / ... ..i _. 1.� _�!!t ,t 't. . f ' .............................................r t ,W a �l�!1J..�i.:.1. "'.�.[.[.riel7:Y5� 'i'. . N...V[ . /�r (1 Ll `J ,d/r... I/��/�./�r✓��! �.. W ............... .. 4}XX J ....-..-.. ... Installer Address �� QType of Building Size Lotlp,2 .............Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width....._.......... Diameter................ Depth................ x Disposal Trench—No..................... Width.........::........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosi t ( ) ~" Date. �l 1 a Percolation Test Res 1 s�, Performed by. :...!5_so�ikl-j:............................. D_..... _:_7_.�........ Test Pit No. 1 ......minutes per inch Depth of Test Pit.................... Depth to ground water---Mm�q....p/.vavIr `5 Test Pit No. 2.-�L.4,1........minutes per inch Depth of Test Pit.................... Depth to ground water_- ...&V o .........................................................r1-•--------•-•---- ----- ODescription of Soil-- - ...�c? -],n:._ �/.►s=S------•----..t--- 1-')...........A-u.D......=k/---------------------------------------------- x U -•-----••-••-••-------••----------------------•----•---•-•-•••-•---------------...-•-------•--•----------•--•---------•---••-----•--------•- --- . •••-- -- • --------------------•••-------... W ------- --- . ----- ---- . ..... r UNature of RepairsQor Alterations—Ans er w en plicable. � �................................ - --- ---- ---------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T IT 1.;,. 5 of the State Sanitary Code The undersigned fur-.er agrees of to place the system in operation until a Certificate of Compliance has been ' su d by the board h t >gne,. �J,� 7 `J� ate Application Approved By..----• .�. � L� �-a�0- 7�A------ Date Application Disapproved for the following reasons:----•-------------- Date PermitNo......................................................... Issued...------••-------- ............................... Dattee THE COMMONWEALTH OF MASSACHUSETTS , BOARD OF HEALTH) j�Q..1 .'. OF...... .ls?.��19�...t.�?................................ %'-wrr#ifirate of ToutpliFanre THIS IS TO CE. TIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY..--...�-1 t��...f XJ?1.I.�ln/ ............................ / I staller j at �,s1 �1 3CL 1,��1- ..1_�.1.11, J_ ...--/ �� � ......�._L-r--d .............. has been installed in accordance with the provisions of T r of The State Sanitary Code as described in the application for Disposal Works Construction Permit No............. ..V .........__...... dated__... ............ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7� v..l1�....r..............OF....1. No.......... ..... FEE...�`5............. Disposal Works To a�trudion rrutit Permission is hereby granted..... .....n01...146/_14..4--------------------•------------•.-..-.......------------•--•----•-•--- to Construct Repair� ( an Indi�ual Se'rage Disposal System at No. � .-�••-�!r,� ..-�.1✓....1 �.�.11.5�. - A...!V.h!__t I.y-----�---'�_-----._.._.6..�6.U..1............. Street as shown on the application for Disposal Works Construction P o,'t N Dated.._�_-�V.'71...........A44 f� • --................................... Board of��-- - -- DATE................................................................................ r FORM 1255 HOBBS & WARREN. INC., PUBLISHERS No......................... Fizs..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH d ...... ..... ... OF ........................' �. . ' ..t}.. ..................................... Apphraation for UwvoiiFal Works Tomitrurtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at .... T.......__...... : .. ................ -- Location-Address :. _ _ O ner s W _!9 'I_�.I ...�v• ,.� f� �Aires .. a --------' ............... . --------•-••---•----•--- .................................. ..... P Installer Address d Type pf Building Size Lot lu_________________Sq. feet Dwelling—No. of Bedrooms k.........................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—T e of Building No. of persons............................ Showers — Cafeteria Pa Other fixtures ......................... -----•-------------- Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. W Septic Tank—Liquid capacity............gallons Length____---.__--•_-- Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width........... :...__ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter......__.___._...... Depth below inlet.................... Total leaching area..._..............sq. ft. Z Other Distribution box ( ) Dosi t ( ). Percolation Test Result P�rformed by. ..-!'-Q:?va- -.•--- .......................................... -•• ------•---•--------------------•-• 11 d..e.12- --- .Test t �. ... _ Date. Test Pit No. 1 M n ------- per inch Depth of Test Pit.................... Depth to ground water.. (a Test Pit No. 2 __. ..........minutes per inch -Depth of Test Pit.................... Depth to ground water 1 lti L.ti lO�s li11i 1 � .................................................................................................... O Description of Soil ` ...........L. _Y-.r.._.. .a.!' ------ -�--..� ------E�&..----•--•----------------------•---------•--- x W =-------:---=-:._...---•-•---•-=-------------------•-•------•-•-•-•---------•-•••------•••--•-----•------•--------••••-•••-------•••---••••-••••---••---••-•••••--••-•••-••-•••-•------•----_...•- UNature of Repairs or Alterations—Answer when applicable,.________'_----------------_..................................................................... A -•--------------------------•---•--••----------------------•------------•----------------...........----•--:..----------------...----------------------•------•-•-•-••----•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT .L 5 of the State Sanitary Codes The undersigned fur,�-lie agrees; of to place the system in operation until a Certificate of Compliance has been ' sn d by the boar he It . 1 ri :r t •. G ��j�---- Application Approved By. ';= y1 Date Application Disapproved for the following reasons:...............: Date PermitNo................. ...._. Issued....................................................... ' Date ]THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....-� 1: .........oF.........( .: ` f .?..:. .......................... ;r T rtifiratr of TonapliFanrr THIS IS TO C4RTIFYI, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.......J.1�_�..._ ._} ��� �-�.............�-. nstaller at f.._u__ �__.. �2121„+J.__ .. ° ' !�/_ .. ..._ ..`L `1!�J�I�.. f � = has been installed in accordance with the provisions of T 151— The State Sanitary C OmA dkcri� in the application for Disposal Works Construction Permit No......................................... da.ted..--------;_..................... ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT/THE SYSTEM WILL FUNCTION SATISFACTORY. � P ° DXTE....................•-•-.._.......----•._........._........------......---_..._. Ins ector---•---•------•-......------•. = -' } I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q ..............OF...). - . e,...�. .:f::?:`l `= 2 ' No........... ........ FEE........................ Utopop at Endo Tonutrnrtion Permit Permission is hereby granted.... _'I...... '- ..................___............................................... to Construct ) r Re air ( ) an Indivi4ijal Sewage isposal- Systein atNo -. �. ..........................� '..1 `.�......_ `d'�. ..."� f ..... ................ c.. ......__ .._...._..._ S et '77 as shown on the application for Disposal Works Construction R t N Datee.......................................... _______________.........................................._ ........................................... Board of lth DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Fr tr ,�� f•� �Y A• tf4 � F �� �V.o�� wvranw+n�anw.�..rrur.+vsa�..• •..u•s..•�ww�.� .,�� '''I i �,,.i F _7 ill 4 f o2 G 0, c p 49 q lao, I r;•1,�, c. 'K/Gdl i h ' 00, we a. ly i ,3,t •t a n y .. / �J1 �j �l x T ytu '� `Y• v a£a�xi 1 , 1 y k � i a EGEN�D - i�y v� , �� ,;7 ,•Y�ir F }! ell�� yt Y't> _ r CERTIFIED -PLOT ' PL,�AaW � Ti`i�G fSp(JT ELEVATION ®xQ / R'11. r..T r X %j I N G = 'C ON.T O U R t._ .. 0 _' /; ram.. ,.�,. .� �.�v, � ,�• a s�. - I�1�1MED SPOT ' ELEVATION 0 0� ��'� el� )� .s w r i�a q,�t /�^ - .. .,._ 1 'i1'D 2LJt.2 r x S A' I N S , �OEpi BOARD OF HEALTH l All N ��••�� A"��, rd ' iti�� � '"' ''AGENT -- --_ _ = SC ALE /_® yG _ DATE, ,rCr' M6L f'L DREj GE 'ENGINEERING CO. lNG CLIENT EfISTE.RE REGISTERED] B N - 7 �pq gUl CERTIFY THAT THE. PR®P`0$1=0t;; 1 I � 9 t • I 'r `tri (� LDING SHOWN ON THIS PL.`AB� y 'CIVIC LAND ' ! CONFORMS TO THE ZONING LAVi!5 + ENG}INFERS, �. SURVEYORS� DR BY ! � D — OF , BARNST _'r r.. :.; 7 12 MAIN T . CH. BY --._ ... -- - 2 2 7 A To- 1111 11C m7 � A W,--' A. 0OR,6 7-Qt :,V W.- APA A/0 APO,00 4VY CtA 7' /�`01^/ 1A Y, o. _. Ci A®E �C3VE� - comoys V oar., CLEAN -5A/V 10 eA 'LAYER �AS7 4 10 OF 0 0 . o 0 o 0 WA5H,=D 5701V,-- L M I/V rcq DISr 0 0 0 0 0 0 A/X SAff)orlC 7A ® 0 0 A, BOX B 0 0 -F, -7-1 PeLr 0 17 0 0 0 D 0 0 o * 0 0,0 -.7")00 PRECAS r SAF-45- V Co o 4 IAWCA�r El-R&I-47-IdONS INXERT AT 64111-DIAI& FT (SEE7,qdL,11-.A 77)OA�) 1 1V4E7 SjS�P77C r,4 c r F7. 01AM. C(5 /lvi OU74,67-SEPTIC 71TANX -Fr. GROUND PVATEN T.4 -E- 1lv4Er v157R1451/'volv aox-ve"a-F7 F7 SEAVACff /..V4.,=r 1-,--,4 cq lvcr c;v-r Y jF7. ATION LEACHIIV& 0 DIMEIV51 0 A------? -SCA L- 0, DR516N CRI 1A 0 1 AfRM -,=T T. G,4A?aAG-F,&15,PO.SAI- 4/,V4,;- 7'0TAL .e5TIMA-r.-t> .4-J-OW SO AL 77,55 0,41-.1,0A V- Soll- 7-=S7 Ivu ACNIJVC -Pe-r-s I/ -�-/ --A/ 0.= SO4 7 ;2 AVER-0,= 4,e C7 & , la DATA TEST p 7. W1'rAVZ5SA-A y 51404E IeACA41M& 60 r-ro/W A_- Ar '.'V,/J)VCH A CNIVCr PE Pt 4 g"g 7,0 rA 4 1 W)eCo&.4 77 0*4V*PA7 -e.4CH11*lCr ARC-A =7. ew 4,EACN11V,5 AREA SQ. F 7. 4: p BUNIKIS -rA 8VI- p -�S ' -UE?UNK Iyo, rt -2�2162 ,.6 110, V 71 -7 Ia -,�-TV m 4,6 t j Y iy F1 1 •'6 r. _-..- -_. .. ' e6*ii�r ir.,r *p�, .:- �r ... �...I, ``a e,t"�:p t� +e1rv4,y��ks ( _;Y`...6t t�:: `� _. 4 , • e , ' t-. xi'� ��. ytaJ aF�''F ���tr$':. `��.�133`Y N f l-' + Y/'3!x M,' } r i t }��•:{. � � 'R r,. f -r f• t r��. � F �w y�A " t< �,�•,, tt x')"r�pL �� �`F: �} � _ A'S.. 4 i,.. ! + F = It�t/I J,'��+e`r+��Y� ! .+ !Y tt tx"�` �` s J�tii ,1 +'• `* d + { ai "�. +,}"W kv w f ��:� _ a", a� Y�i`'+�+t 7) R�' fi� -,pr! S� ,-�%47 "�.y {Z' � + ..lY•' tix.�f,- 31 •, .,. �. t•. '" ;ilr ," rfxi tT Y}ll 'r et 1 :5 t ;L.Cr/.�// G( g..YI.. tl//}, I,7�(/!/�V 1G13 'p� b / BOG ,r�1 1 4S v�^• { s� , ,. d {ei, + v .. ! '^. r, .,��; Gam'' f�. �`t'ETF Nye �5� Ar �, t��x i,L"-':. fr'�,�,� t• x �.r -. 1 1 � ,{ ?`;® s,~� t �''��- � _".�•l V f N .-...� __.4A9 ���.�A � � o-- - �cs_t!a-Lj ����E�u r{zI t+• I + }r_ qr �� 1 �{i `3 ':k. f. `i,. '� i••` 1 T.4!•"Y fYba at. \ �.1'l 5 1� L � y -.-;5 F� '!,� r >,i r f N f rt��y.:-•-� 0 ��" } i� }- '•' 1 �,pd w� '+11 ��Y .' r�{1�r 1 }S tk AV t � A[S:'61 °8r �.+i 3y�Zf fq r�•f, S -+ 411, Imo+ •A/( �'�9 -. .- /�. �! ��YJ �t�+ t t1.1 4a'S If �� Fjt•� iy s ; I , r Y+ .�� �,. ,.. + 9 1 "�yf � y �U1 rj�_ 1 X 4 «e F3 r .,1: I *+f+ 3 'jY rf7.r'•� �` tY r r,1 f ', - � , i i..,1 �,. ,i !+k Y }r� fsk fl��tk�•�i nr ,. Ali � i i���A F a , a:`rrr LEGEND CERTIFIED PLOT PLAN ` a a EXISTING S"POT ELEVATION 0,0 - _ _ _ ra NG�.(.`U IV ( V V r'(""— w"�-lJ w'. ""'�FvI"'°'m"^�,. .wr`^T—. / -r<- ..�...�. P Ai•..... �` ;0 fB *, L we3 1 — 1 L, n I 1 1r• r ..� � � > .v / •i� • G !� d,., 4--� "F4F.,-1 FI'NISHED.,••`SP0T ELEVATION 10 0 F1tdiSHED CONTOUR 0 1J2 ,yry �•�� -..! f ,1 41�4 '� "APPROVED. ='.BOARD OF HEALTH 1 \ e��� +{ �V: `} =f rly .. .1 �{} :if + ,Ii •S, S�Y01 A- .m�Y/�8 p ,�e.• � AS. d 1 '•'DATE ;, i AGENT SCALE � s/G � ' DA'TE ' l�e��j/���: t ytt� IELDREDGE ENGINEERING CO. INC' G' MacCeL_t�y I CLIENT I CERTIFY THAT THE PROPOSED JOB N0. 7 y09 1 EG�ISTERED�j REGiS,TERED BUILDING SHOWN ON THIS , PLAN IVIL. LAND �� C„ONFORMS TO THE ZONING LAWS 1 }�,E'NGINEERS I SURV.EYORS)` DR BY ! OF BARNSTA 'LE ASS. _.. . 27 �{ M�,!ti �T - 71? M=,IfJ CH. BY F /V07 L577'Al IC'-7-AAII< OR, P7 AqF 7A,,V 12"SEL 0 PV AO&,p A g? *WfAf SNAIL/- &.C- 8 MOvdSoW 7- 770- 4:FA?A,bZ. /V J Ax rRPA. ColVCR&rR- AVY CAS7" lloeolA. -rc'q MIAI- PITCR CLFAA1 .SANG CC) P114E IC? L 2 LAYER 4" CA57 C)-IRON P/pz OA4. © 0 0 0 0 MJ Al.P'JrCH WAI 5 HF&5 7011YIE v -�' 0 0 0 0 0 a '� 4 J.'r S,=PTIC 7A- AI/< ® BOX o 0 0 auo WAS14,F0 STONE o e eD o o ®®FECT7VE D c a�. ` 3�4"---/.��2� ._.- 0 0 a I 4. 11 0 0 -I.__ PRECA5 7-SA- A&E' P1 7 49 A91,4 M 1AeV r . &,R7 AT A9Zlll-,Dly& 01AM. 11 . : c(,sEe -rA&LIL A 7-)OA�) I ET SCRTIC '-rA Fro F7. )V4 SEPTIC 7ANX OUTLET 9C,Z Fr OR04UAID -WA7-ER T4BI-E SOX -A7 SdEC7 BOX F7 TEAVACH DISPOSAL SK57W-M 1,V4E7 4.E-ACH1lVCr )C�•V-r FT -n,41 at//-A TID H D/MENS 10 Al & K DES16N C-q1 1A 'o 1 o" 41oVjlr SOIL Z-0 C7 (74RCAG" .015A705AI 7-07 .TEST A/ SO/4 7-67ST02 ;2 AL e5TIMA7eD GA 4.1,9A Y SOIL 7,5 -Z, OA 7-E OP- 50) 7-"= 7- N- NUA18ER OF -ACXIJV6 P) .5 AF44rrl.- 1- .5 -LleAcHhV6 jz:p4=-jl;r 44=1 s(p. pr JL � f > SIDE RESU'Lrs Mvlry�-ss--� EWC0,LAWON WAT0 aOT-rom LAI CHIN& *CIE R r PEPC0,LA7'10M#"VA7'—'=1*2 7,orAl- LeACHI&Cr A SQ. F7 RE5,FRVE ZEACNIA16AREA SO. F 7. .10 4/2' -4, A DBERT.' 4- BUNIKI co L r 71 1 2 A sr -22162 %-�' � — " ` " 7 J*IV -4�1:NO`?V?�qwv � y Nf 67 55.7 A � q^j0V7H, HYAMW -vco WA TS rzw 'A(Z C3 �7 Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Rons Truck Shop, Inc. .-........................ ------...--------...------------------....----------...--------------------------------...--- 52 Thornton Dr., Hyannis, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ III Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- Restrictions: .-----------------------------------------------------------------------------------------------------------------------------------•..-----------------------...... This License is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF, D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BAST ABLE 4 HFG.NSTS NlI -05TERIL,VY R•FYA1115 ' ` Public Health Division MA?S bN5 M15.639- L'c•YFSB0.N5 A&-E 639-2014 1 � .SrAB : Thomas McKean,Director ti. MAE& a 1639.y166` 200 Main Street, Hyannis,MA 02601 k Office: 508-862-4644 ,i Fax: 508-790-6304 C"$ y. M. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE '` f 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, 1111 —`499 Gallons: $125.00 El CATEGORY 3 PERMIT '500 or more Gallons: $150.00 *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS.A PERMIT RENEWAL? r° YES NO.- IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: on S Iry ck- SVI.Q o 7Enc,- 5. NAME OF ESTABLISHMENT: S a - 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 508-- p2_46--13g6 okFtcst 9. EMAIL ADDRESS: V1 1416 @ rc3_nk-6C_Ae_'. 10. SOLEOWNER: ✓YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME onS yNo c. . ° a3allo PRESIDENT VA a-l+e t 7. G 1ov.%0XJU t°t rs:Aa to is wvAv �A A ,TREASURER o qd 20.,_L ''l &r n CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS . EMAIL: SIGNATURE OF APPLICANT ATE Q:\Application Forms\Haz Mat Appli Draft Jan20l9.docx i ar} Number fee 187 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Rons Truck Shop,-Inc. 52 Thornton Dr., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------------------------------- --------------------------------- ----------------------------------------- ------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. --------------- ---------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable I Inspectional Services BARNSTABLE Ft —SIME_Us-,0E'ali.L•CO'l R 4N li Public Health Division WP5T0�"'�.5°9-2n14 9BMMSTABLE.$ Thomas.McKean,.Director - hC `l'ArE1�39p.�A`0 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 T, 1... 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 1st—JUNE 3Oth). 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 J V61 *A late charjze of$10.00 will be assessed if payment is not received by July 1st. b11 1. ASSESSOR'S MAP AND PARCEL NO. 0�9l(✓ C� 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: oLd°-2-v T. G[45 LA->a CA-L- 5. NAME OF ESTABLISHMENT: on'S Iry CAL �'1.oP T L 6. ADDRESS OF ESTABLISHMENT: 5 a -r h o�m -o n —b-r t v•t- 4y. CL nus— HA OZ 613 8 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 7p Kj°`mom C.LAt HA °zgst� 8. TELEPHONE NUMBER OF ESTABLISHMENT: 5 0 S-"191- 5 4.9 9 ( 5 08.2" t3q(), 9. EMAIL ADDRESS: t 1CIC► �. Ifl Ct t"1 �y C� 2�• 1"12-'�' 10. SOLEOWNER: ✓ YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 508 -995-t391 CORPORATION NAME 'Ron'S -rri)Lw— Sh.oa-In L 'P 0 6-OY I46o t-4A o2sS4 PRESIDENT In1 a.0,{-e-r- .T G I o-Lo cL -Ll - Po Boy- Yt-00Ln+-V-CLLt ► A ozzy- TREASURER NLCJ-t0Lt tj gx Ax"L 'T7o bo*c " tj a +vc k-v-+ i--tA CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT � TE 5 17,3 1 Ll Q:\Application Forms\liaz Mat App Revised 09-10-18.docx Number Fee 187 THE COMMONWEALTH OF,:MASSACHUSETTS. $150.00 Town of Barnstable Board of Health This is to Certify that Rons Truck Shop, Inc. 52 Thornton Dr., 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 kft a + !t Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Rons Truck Stop 52 Thornton Dr., 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 Vwofor B Vnsxable a o 04 a� eg atory ervices Richard V. Scah,Director �z Public Health Division BARNSTABLE • wtNsraetE•CalivMUE•[oNR•xvaml5 tr;Y BARNsrABLE, ' Thomas McKean,Director """VM-J�OMR m4� 111D 96 •�� Sag t10 .erEo�,�a 200 Main Street, Hyannis,MA 02601 ( �_lh a) M, Office: 508-862-4644 Fax: .508-790-6304 X. imp APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALScn 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 charge of$10.00 will be assessed if payment is not received by 1st. 1. ASSESSOR'S MAP AND PARCEL NO. aq 4 o t o 2. IS THIS A PERMIT RENEWAL? J 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: Wo.,+e.r T. C:Aowac cC 5. NAME OF ESTABLISHMENT: -Ror�s-T',►z�e�c ey IRrn , 6. ADDRESS OF ESTABLISHMENT: 5a -Th orn+'O n Tv-. -�lo nn i s , HA 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ?0 6oy. 1g6,0 W o..ti6cic.•t "A o-;ks% 8. TELEPHONE NUMBER OF ESTABLISHMENT: 508-, -1111 -54ctq 9. EMAIL ADDRESS: ,t @ rl o;v�-4-y SIC +. r1,e+ 10. SOLEOWNER: J YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 5o1a-228_ mck to +vr all CORPORATION NAME Ron'S,_ry c k- ZIn c- • T O Pa o x 1 Lk too 1-�Mn}L L i PRESIDENT W o,.+ex -S. Po l50x a8 IS0.,- TREASURER t4 C car LaVg, N o-6-e� Po Pbwt aoa o►44tx1 + HA o,>b� CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: f SIGNATURE OF APPLICANT Q: Application FormsEAZMAT APP 2017 REVISED.docx V. Number - Fee -188 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Rotary Collision Centers 345 Barnstable 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 O' 4 ,t Tow of B nsxable egulatorygervices Richard V. Scali,Director OFfNE Public Health Division BAMSTABLE ry � W.NSiMIE•f£31TE1MLLE•NNR•HYANNIS BABNSTABLE, Thomas McKeanKAS& , Director ""�iDM1S"'�lea 0-WY 8 SymE - 059. a``� 200 Main Street, Hyannis,MA 02601 575 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 ` 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 x VS, *A late charize of$10.00 will be assessed if payment is not received bey 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? V/ 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: c 5. NAME OF ESTABLISHMENT:TQ f(kum Co WNg1rytA Cad UkamY11 S 6. ADDRESS OF ESTABLISHMENT:�,5� � � &L-inn'l S ouspi 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT:(npQ) -i-iS - I�)V3 t 9. EMAIL ADDRESS: umiau[Sri can oAm cam 10. SOLEOWNER: y"YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE.#OF: CORPORATIQN NAME-M� G rOoo kvk&, PRESIDENT J V9cDrW TREAS CLERK< 12. IF PREPARED BY OUTSIDE PARTY: NAME: T EPHONE#: COMPANY ADDRESS IL. SIGNATURE OF APPLIC DATE Q: Application Forms AZMAT APP 2017 REVISE Aou 1 4 Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $150.00 - - Town of Barnstable Board of Health This is to Certify that Rons Truck Stop 52 Thornton Dr., 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. 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 �k Jun, C5 2017 08:40AM HP FaxRons Truck Shop Inc 50895729525089572952 page 10 k of oB nst ble ry Richard V. Scab,Director + Public Health Division B I�AB�S7TABI,E max, • RA NAM �.aa:U6 MYl V311MLLC•9ilR./1I.I1! "�` �,►�. Thomas McKean,Director ,„•201i �4 aua'' 200 Main Street,Hyannis,MA702601 9�17 - �, Office: 508-862-4644 a N1 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS 1N 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 1st-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 RV. J *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S VIAP AND PARCEL NO. 611 010 , 2. IS THIS A PERMIT RENEWAL? ✓ YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/13UILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: OT- ' V 'Mrt G . 6. ADDRESS OF ESTABLISHMENT: JC r r�rrOrl r 1 v!Z t11'115 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: TO 8. TELEPHONE NUMBER OF ESTABLISHMENT: 508-q q 1 -S%4 9'1 9. EMAIL ADDRESS: n h 0 n�-u 10. SOLEOWNER: `�/YES—NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 508-ug-13q to .� ail CORPORATION NAME oCl�S 7—ruCIC hors L ` o bq 1410 C> �af7� )LIz� PA OZ PRESIDENT }e t 3- � V TREASURER , p C. A D2S CLERK PO o lam( 1,tA oZ 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL. SIGNATURE OF APPLICANT ] Q'APAlication FomtslllAZMAT APP 2017 REWISMdo c i Number Fee - 187 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Rons Truck Stop 52 Thornton Dr., Hyannis, MA ' Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ---------------------------- ------R-----.----------------- ------------------------------------- ---------------------- ---------- --------------------: -- ------_---------- ------------ e . This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 1 � — ,w F• � • c I r Town of Barnstable ?15llP / �tHE� Regulatory Services i Richard V. Scali Director . .��AB� • BAMSM M $ `-Public Health Division LLE.fDNR• Ak„A 1639• ♦0 rupsrona raus•osreanue•wsrenn„sme� QED 1i1°'�' Thomas McKean,Director 16 -2 ' 200 Main Street, Hyannis,MA 02601 ry 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 ._._L -ANNUAL PERMIT(RUNS DULY 1st•—JUNE 3 Otfi).�-�-� ��'�`�_' _ -""-"`�°"` `�-""._J-.g,:.`-"�.':`� -T' `-�"" - -_ APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 ERMIT 111 499 Gallons: $125.00 ❑ Y 3 PERMIT 500 or more a ons: $150.00 V ;S • A late charge of$10.00 will be assessed if payment is not received by July 1st. , m �-` w�t: ,yw �..a;.,, x v>•::.r Y �+ .:�- t�ix :.�,.� :.... :,".,. .�J�'<x snd44:.. . ,,.:. �;t.,;�.s .k¢x•-fin .�,+,t7:i: {�� �t;ir A`��...}- w e h`�t^� py^..5..,wP:..��t.}. ,, R,..<�f. R h� ,:.�.�i,�an ':,:��sF .r.;.^:,. ,,, e .Y .,a•,t„� :a?.. ;+5.,,$- ..447z.{ilY .:�.:" � 'i`-s ,r� 'a! +#c S /i `tw.w�� n+a.;$'S.}.. I a�( ;.c y�l�;}F :.... e,}'�v Y;, .!.° �' t 8."�..:.'�x.;}}�:r. r� ..t.�� arr:¢¢.�,s � fir�.�- *x ,��.L f a.#3'i��'n+L .,,.�;:.�,a:."+ . ;'-.� 7",..ha .k.•.:, q u ro;'�,,,ztv >*4 �.. a Jd�rt.., a .t;.,. }vp� xi',':`. der ..a, :.'+.a "�•5'a_•�••,, ,.L.4.J -1 ,4,s�, 1.,. a v+� .,y A�,., .�?... ,.�., � �. a't,'...4y+ .( .s 1. ri.ss5f�,.. <�.�t �d�S.. e.N..a. k ter£% ,.,t+z��,,..-. r f. rj•:.�91., "S'"n �,n �a�+ ✓x R3- �$• ,h'�a ^4� .r-..£.,, �(}i r. .I .�7J'' is}.:,f.;vy. i.,i.� 1. ',4 4,•. t>�a;,.;x r,EyF,to...- r 1< ..:.r �K� '.:f :+ .,x ;.',:,,.. rn`>>r f-:f%.}: ... ,�+'�3 ^....� .n r:. u,..;.• �Y I•. ;:� .,:..i r ,.4 � ..7 u. C,Y:"/"C..-J: },1., Lf}. g..�N. L .�:. �tY 1r,^f`.;t ' .w-.rf..gig'. Fir„xg,,^�;�.F y3,'+.�•� i.-.i>i.z S'n° ,Yacy_:-.$�' ,Y��.'�..ix::sii ..-i.r� ask,:.. 4..� �. ra `ox'. r!",• .a , .:.? ip.x5rfi: fNS n:d;Yrfi§ ?,h:.,t'E!u Yf"q....•..,.t'�N�}a,.. • � F-APPL`ICANT.. .. � ���� '� •�t'C'7��� �r�r�,F�>r, ?::�� r`lr��r,:�r.� '�.�a.����.::: `�`�'1 �;�•=��a�`0=:, NAME OF ESTABLISHMENT: VoM5P ADDRESS OF ESTABLISHMENT: a r 1+-6R W DQ - LN&NMS MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: JC EMAIL ADDRESS: 62 AA/1 L. SOLE OWNER:AYES -NO' " IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT 03 C fEa � R0ZV:90 TREASURERft&AA VOLC • T .t , .IF PREPARED BY OUTSIDE PARTY: S RE Name: l Company Address Telephone#: Email: QA,Apphcation Foans\l3AZZAPP Rev16.docx Page 1 of 2 Ftne t Town of Barnstable Office: 508-862=4644 Fax: 508-790-6304 Regulatory Services Department '='�swi�srnsL Public Health Division �+ Thomas A.McKean,CHO 200 Main Street Hyannis, MA 02601 Payment Receipt i Hazardous Materials Payment received: $125.00 (Check) on 7/5/2016 Permit number: 187 Check number: 040651 Check amount: 125.00 Name on check: Ron's Truck-Stop,Inc. Business: Ron's Truck Stop Owner: RONALD G &CATHY A TRS Address: 52 THORNTON DRIVE, Barnstable Note: Category #2 =$125 .. c �\\ Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Torn of Barnstable Board of Health This is to Certify that Ron's Truck Stop 52 Thornton Dr., 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 Town of Barnstable �WE� Regulatory Services T • °� Richard V. Scali,Director w r a ► Public Health Division iOjEc�►+' Thomas McKean, Director rho 200 Main Street, Hyannis,MA 02601 t1 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 tm: ASSESSORS MAP AND PARCEL NO " DATE 1 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ROKALP RACH-E-C-0 13 x i�J�NAME OF ESTABLISHI��N1h � ;5,. "V r r.?'.:-�25� a d.i pi•r...:;- yy,��yV .�tV ,�.a-'x:;: s ��-c_.� �...":a s{J. k..., .. �yytt - ,t•sr -.: j i,.a:-.c,..n.... ..f ...xA ..: :a,<. .n -w �'(�"E'- ,�^ x �9�4i�*i'��Kr:d� .�. "x. i�,zt {*.. y.f•�P Xe., 1•i(,j3 y �f.gy'AsJ%., ,-:,rF(Y�IV�".•�.,�•�5 "Y'q..Y�* '�t y .�.��` Ar 1.ty,f4. kiJ'1h'`.j•Y .��.h '� y�"y'�'�.:� tX... -.:i a ..�^>.;..,s' ::.,..,. iYr_ 1,. _l � Hrs„'o;`#G -1 [,,N, y., i,';1�� ±�.. �� .6<,�,.�dt �-''s�e17 »J. - t'•.ce:,-.� qU.r. ;ret� .,�..�r v�. -yvgl.i,$. y�J,�r•P f+.,..�Y � 4 .,� 5.'c,fi....:f' `�S,$9;3 q i'4 �;' y tt pq ¢ ":^ .:• �'�S ye - :l,��' '��:.� �:�?F-fi}'t b T. �.tdF •'�1 g i5. ne > M,f i 1 �, 1 -:�, r4•�§-F.. 4y$;-.;�2Y*'far;,'...i` ,r ,i�;.:r ,��d. 4•ef { f�..art•A �p t rs'�'l.�j TELEPHONE NUMBER Q D I ck5z-C9 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS _ a IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: a PRESIDENT ' �ON PVUD PAeqetCo TREASURER C-Pfflhl 1PA0A EC-0 CLERK t • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS F�63 � }�R( C- �, 6Z536 HOME TELEPHONE# 15 l'(,n C:\cache\Temporary Intemet Fi1es\0LKD3\HAZAPP Rev2015.DOC pk Town of Barnstable Office: 508-862-4644, Fax: 508-790-6304 Regulatory Services Department • : UA am Public Health Division Mom. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/12/2015 Check number: 039840 Check amount: $100.00 Name on check: Ron's Truck-Stop, INC. !Business: Rons Truck Stop INC Owner: RONALD G &CATHY A TRS PACHECO Address: 52 THORNTON DRIVE, Barnstable i • Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $1o0.00 Torn of Barnstable Board of Health This is to Certify that Ron's Truck Stop 52 Thornton Dr., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------ ------------------ -------------------------------- -------------------------------------------------------------------------------------------------------------------------------- ---------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2014 - unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable pP1 ME Regulatory ,Services } Tomas F. Gefler,Di :ctz)r a SieANC7'AAYT. 4 +•.xt ° r } e, F'"ffihl�9 1NiF r.Y Ac t1e act )A w'^ 3f }S;,$nx vi 4 n. �.rrJ ..��.•i) gi� .�j�0. ,.y�.'i 'It �'ri4 ;t `Yi i3'! s�l6 z �"+f.`yrf ,� h. i ,.,%'u '4 `d' Ida try L1,�t �i k'.z`ff �X hhra'" T 03Il25 1�Y�C E Ilj M1 ctok 200 Main Strom#; Hyannis, MA 02601 Offics: 50&4b 4644 F= 50&790-63C4 r A���ioa#ion Fey:,$'�00.00 A-SSESSORS MAP AND PARCEL NO, ( DATE APPLICATION FOR PER�= TO STORE AND/OR UTTT=.MORE TE AN 111 GALLONS OF HA -ARDOUS MATERIALS F=INAME of APKJCANT n 1 I N-A'U OF FSTABLLE'T -To cy = � ADDRESS OF ESTA ISIL� i'i = p TELEPHONE © �?rlI 5L v9 , SOLF O WNIR: YES NO I F'APPLICANT IS A PARTNERS', FULL NAYM AND-HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPQRATION: F=FR.AL I EN=CANON NO, 4 D Do-] STATE OF INCORPORATION YV� :PRESIDENT.NIE AND H01 A�DDRFSS OF: Ln Ch, \vrjaS, i_ I'ff, U O l l 82< ATURE,OF APTIJCANT STRICTIOTS: HOME ADDRESS HOM T=HONE # F—doc/wp/q j l 7(ut 'GaS Walt 1S our Cf'l �rt�CP 1, r �l i SPILL CONTINGENCY PLAN . Emergency Coordinator,Name: Address: VVIA CM tO V V1 Ls. . Daytime Phone: 15)K 711 t,_541:2j-7 Evening Phone: Fire Department: 41caMLS -7 Barnstable Public Health ivision: 508-862-4644 f 'DEP-24 Hour Spill Hot-Line: 888-304-1133 Waste Hauler: Name: .11�r Phone: 1Co 103 Building diagram indicating�hazar_dons:materiaUwastestorage=area, location of absorbers -scavenger material`s�fireextin-g hers�fire_alarm7s (if present); and evacuation route (if applicable). (1/ rw t�J G1BGl C ,ce 15P � . _ �° door Ge;V'�: �`.- ey,+ _ F Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Ron's Truck Stop 52 Thornton Dr., Hyannis,MA 02601 Is Hereby Granted a License FOR: •STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. �S ----------------------------------------------------------------------------------- ------------------------------------ ---------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2013 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health ' Town of Barnstable 0_p1HE yQ,. Regulatory Services Thomas F. Geiler,Director asax-cram. public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 D 10 ASSESSORS MAP AND PARCEL NO. -4a DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT : Packd:6 NAME OF ESTABLISHMENT, 7 ta � , N s: •1� rat t r.. ao.? ..` 3�" ADDRESS OF ESTABLISHMENT. TELEPHONE NUMBER 6440 SOLE OWNER: V YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IT APPLICANT IS A CORPORATION: FEDERAL`IDENTIFICATION NO.. 04 'tea-]79a,3'' ek STATE OF INCORPORATION dVl. FALL NAME AND"HOME AI) SS F: PRESIDENT" - ©2� TREASURER .. CLERK 1 SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 'SLOP HOME TELEPHONE# 507 54S 1,51 Haz.doc/wp/q III � � `� (/�, ��� � ;. � � � (� �� , . � - 4 f Number Fee :187 f THE COMMONWEALTH OF MASSACHUSETT:S . .$100.00 Town of Barnstable - Board of Health This is to Certify that Ron''s Truck Stop :. 52 Thornton Dr., Hyannis,MA- 02b01 -� 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 6/30/2011 unless sooner suspended or revoked, --- 1,4 - r WAYNE MILLER,M.D.,CHAIRMAN ` PAUL J.CANNIFF,D.M.D. 6/30/2010 JUNICHI SAWAYANAGI THOMAS.A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable f1HE rOk'b Regulatory Services ° Thomas F. G'eiler, Director • r BA MASS. LE, : -Public Health Division MASS. A .. 039. 0MA�A Thomas McKean, Director 3 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee::$1.00.00 ASSESSORS MAP AND PARCEL NO. ( ®I 0 DATE � Ito APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS Y FULL NAME OF APPLICANT QD P NAME OF ESTABLISHMENT Torts q- -wcv a�.y +� t�rah t9 a4 # ",a 4 1 "jt+' .' .Sa �tu"�Y �� �� o-w"r tk '3 f p;., �;. �, �Y 7•i„1.i .. TELEPHONE NUMBER. ',�� • - - - SOLE OWNER: I/VES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL'. PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 04 DM D a'� STATE OF INCORPORATION I 1 FULL NAME AND. ME ADDRESgF: PRESIDENT a TREASURER 03MA Ax CLERK 1 • A.' " SIGNATURE OF APPLICANT RESTRICTIONS: HOME,ADDRESS l 3VVft& — ACP -HOME TELEPHONE # 6�19 648 ["'s 66 Haz.docAn P/q Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health \ This is to Certify that Ron's Truck Stop 52 Thornton Dr. Han --_ --- ---�-_---y ncs,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 June 30, 2009 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health rb Town of Barnstable Barnstable sT � Regulatory Services Department !xlt-lrd • Public Health Division �m nawvsrABM "� � 200 Main Street, Hyannis MA 02601 prEo � 2007 m Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO (p 010 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �N � • ' m p NAME OF ESTABLISHMENT Y ; Et4 ADDRESS OF ESTABLISHMENT Y 'i awk.,. .t'Y3 fF' „ }- � ,6 k nr G it � ' �a' • � +} ax M . �y, � y w try:`*;' s 'TELEPHONE NUMBERYr x. ,t;,k i,� f�a '' ,11z t'�p �4 ': '+� L 'M" i ..'�iry.7-i 1�.f.t �„��i wE.�.c!`.} � �¢ � �,�"a t v�"}A�x �.•.- a.s�A :"�'> t . h s`�' �� SOLE OWNER: YES NO cnUl m IF APPLICANT IS A PARTNERSHIP FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. (% STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT 2nUKLV0253� TREASURER L` CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 187 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Ron's Truck Stop 52 Thornton Dr., 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 June 31, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 55/31/2007 PAUL J..CANNIFF,D.M.D. THOMAS A. MCKEAN, R.S.,CHO Director.of Public Health Town of Barnstable Regulatory Services Thomas F. Geiler,Director BARNIMAIM MA.99. Public Health Division 9 43 ibg9, �� '°r�nhu►'�° Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. !1 610 DATE �P 5 D APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS RM FULL NAME OF APPLICANT 6 `tRUd2 — SOP NAME OF ESTABLISHMENT �� T C ^ �ZP n ,<a wx l� �i�ia,.as a' � ti��r,r' ��t°,h4f q"•'�t�`'�,�f n�4N � � �- i 6r a .£, r�' �i '� >, �' y � z t R tip �, � r.� r� "^n� y-', 4 �J+«i,�� v��a r`Atc`lgu't��h pi �1+.k(J j w t'(1'�`d� !c'Sr"•�.�dk`1M"`�r t�f� k a rtix ki4�t$�� '�'TELEPHONE'•NU10'IBER s � � *��.;� �;-a�> �,,� ' i CD SOLE OWNER: YES NO c_ cif -. IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS 0WV.ALL PARTNERS: ` s_. r cv IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O aaI STATE OF INCORPORATION Ill HC FULL NAME AND HOME ADDRESS OF: PRESIDENT (JAL G Sd3 TREASURER CLERK. . _gyp . .-W�'_•'.. ... ...J. A ...,. _. �/� /'� �-�� SIGNATURE OF APPLICAANca��,�,, P-kW��T -, RESTRICTIONS: HOME ADDRESS 6b3 C&ffiyaA& t' V^' HOME TELEPHONE# 549 l5110 IME rotiti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 7 snRMA�BLE.g` 200 Main Street• Hyannis, MA 02601 �prFDMA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Q Business Name: RonG nxiG Date: 7 /1 I Location/Mailing Address: 53, — or dun At& NDLAhLyk PO 40� Contact Name/Phone: U - V Inventory Total Amount: `" O SDS: License#: �7 Tier II : N o Labelino: Spill Plan: des Oil/WaterSeparator: N/A — Floor Drains: N Emergency Numbers:_ Storage Areas/Tanks: 7 d Uf-�n( �� ��I Cho , Emergency/Containment Equig ntnt: rxbso6m ks, S 6 5-f04"0 Waste Generator ID: /V,J 5( a7 NU aste Product: ai) Date&Amount of Last Shipment/Frequency: � Licensed Waste Hauler&Destination: GU( S 3 X qef-Ir Other Waste Disposal Methods: S' ©� on ` ps 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 Jvlotor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners iesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMEND TIONS: Porri . `I /1 I i Inspector• Facility Representativ •U� WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°FIB roq� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 L'"M��E,� 200 Main Street• Hyannis, MA 02601 i639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT EO P'�Business Name: R®ns CIp GK S� Date: CI7/19 Location/Mailing Address: 5X 1hornfoo Qir i H�Iarrn�J(3a(ns4.t,ble rfla;J11nq. 146o Nu*V,1S6 Vo bars) Contact Name/Phone: Fl771' 497 Inventory Total Amount:-to SDS: 0f)1i nt) License#: o i3 Tier II : O Label a: _rG& Spill Plan: (i e-S Oil/Water Separator: 11 Floor Drains: Emer enc Numbers: Storage Areas/Tanks: ` Pam/ Q1 l 500 Lv , Irc,S�c ` Emergency/Containment' mer enc /Containment E ui en : d r pe &-; Waste Generator ID:&50%77WGUWaste Product: 6 I Anf;�rwr Date&Amount of Last Shipment/Frequency: -4 Licensed Waste Hauler&Destination: ea^ G Other Waste Disposal Methods: S t 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 q E- Dry cleaning fluids —�� Automatic transmission fluid 4 4 Other cleaning solvents&spot removers Engine and radiator flushes 4 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 �l Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages- Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: hee PleiC& ih P-W it U 1pcq Pc� aryl, INFORMATION/RECOMMENDATIONS: hetLf< $ n Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°F�HE rower Town of Barnstable Office:508-862-4644 Public Health Division Fax:Sos-Aso-ssoa BA MA.Aq LE q 200 Main Street• Hyannis, MA 02601 prFC3 9. <"'00 - TOXIC ANDD HAZARDOUS MATERIALS INSPECTION REPORT Business Name: OK! — I `�L 5�q Date: s j Location/Mailing Address: 6 Contact Name/Phone: r ft w '7 I O lti} � �-Z^� �J0�.•�a,GI.G l�k— 4K uC �sSo l Inventory Total Amount: -- 9 7 SDS:V w %� AgL265 License#: 9 Tier II : ` r Labelin : 0 Spill Plan: -- Oil/Water Separator: 1J Flo Dr ' s: 00 Emer enc Numbers- lei Storage Areas/Tanks: 1 vJ�S��o ,� �u y c-o � 170 1C,1 kLLJ p r l Emergency/Containment Equipment: r 6 0 15 0'0- s Waste Generator ID: y Waste Product: of � k K4,E' &-e Date&Amount of Last Shipment/Frequency: w 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. OZ Antifreeze 1?i X(�� Dry cleaning fluids T Automatic transmission fluid '� Other cleaning solvents&spot removers Engine and radiator flushes 1�X Bug and tar removers Hydraulic fluid (i cluding brake luid) Windshield wash M Motor oils 1� Miscellaneous Corrosives � Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil �h� Disinfectants 7r Miscellaneous petroleum product- 03r Road salts grease, lubricants, gear oil 3 Refrigerants J Degreasers for engines&garages\a<XN\V' Pesticides: Caulk/Grout vp insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Zo k\Z 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: ORD RS: Q t4 Z a.\& ' \)A-A INFORMAT ON/RECOMMENDATIONS: II Inspector'° 1 , Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS I►E r Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMS�LE. • 200 Main Street•Hyannis, MA 02601 �FDMP'�A`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: PovlS , Date: 6 z3 /ro Location/Mailin Address: ,a c• �-}�a,n��s ash able Contact Name/Phone: or`- a��a In to Total mount: ' ba k MSDS: OwliNkt, a cctss License#: Tier II : N D Labelino: oa R Spill Plan: e5 Oi[/Water Separator: OJA Floor Drains: o Emergency Numbers: Storage Areas/Tanks: 1-1 o v,A—, ;' O- \ AS 1 -4019 a-1 �.o+I 2 <wK 5 ��A,� A:V,l?<eeZe— Emer ene /Containment Equipment:���d�-<,4 a o�n 5 ��'D�k( i�� I�ouk 6a�Lc. Waste Generator ID: J b_S 1-7 1 Waste Product:�� l , a�t�2����as' S e-kA►^-r Date&Amount of Last&Amount of Last Shipment/Frequenc�; G 1 200 o\ �., eve o-f .r,n,mom(•. Licensed Waste Hauler&Destination: e uvt_ o III ,$�---A 0 Other Waste Disposal Methods: YeA,5 e,1,e-%Kx-ee- 4o a 1 1e�evt - aa� 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 -A Wa�k� 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 4� Motor oils X W D-Sk4- Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: S(. 5 -c s 5 .A C , 50,1 b-J-6 -e),&kvJP o a<vv%-S k CeA4'1•._ Co( t� max- 10�, n� p� � Inspector: d",l.Al�'-2Sx a S 1 Gt ke,.�—`-�p ►'Jti Facility Representative: A Q- ,G C WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i 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,'l st Fl., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. ; DATE: E' Fill in please;l APPLICANT'S YOUR NAME/S- L jA-L-T�2 -f� ra 2 USINES YOUR HOME ADDRESS: 1 -77��S�fq , R TELEPHONE # Home Telephone Number' 54 -- NAME OF CORPORATION: i���T�4JU ©R1U L�L-�� NAME OF NEW BUSINESS '���3`S' Tl� UC�I� j . /� � - •TYPE OF BUSINESS IS-THIS A`HOME,OCCUPATION? _YES NO ' ADDRESS OF BUSINESS a MAP PARCEL NUMBER. 27 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 'ad..&Main Street] to make.sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SSION R'S �OFF I This individha nTo ny er requirements that pertain to this type of business. A h rized-Sig at l CE)MME TS r_ 2.QB6ARD OF HEALTH This individual has been informed of t 9cr I it r irements t pert ' -to this type of business. MUS" COMPLY WITH ALL �� HAZARDOUS MATERIALS REGULAT! = Authorized Signatur 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: 1 ' °at►�►ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 snRMASS. 9• 200 Main Street• Hyannis, MA 02601 .639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rf0 MP'�a Business Name: �� ao Date: Location/Mailing Address: 2 oc o c.ve av vi 15 Contact Name/Phone: O e Ca CAA P—c.o oR>--7 — -T 7 Inventory Total Amount: ti70d k MSDS: 4VQ,Ik4le License#: g� Tier II : Labelino: l`e- A e e1Vn<eCV--Spill Plan: C5 Oil/WaterSeparator: A Floor Drains a Emergency Numbers: el Storage Areas/Tanks: t'70 1a1 .n,.w o, AS 2-Bo Emergency/Containment Equipment: Waste Generator ID: MV5-0$-7-71 y Waste Product: 01 Date&Amount of Last Shipment/Frequency: `N, o% e.► 2 3 n105. 1 1 4-1 Licensed Waste Hauler&Destination: 5Je+ <�e-e-v` z j 11 K, I S a GIeAw--1r Other Waste Disposal Methods: `- I r LIST OF TOXIC AND HAZARDOUS MATERIALS Av 6kq v< ovl w,` — ,Vl I KVPA'K 5 IPIC4f, Lq5+fK!5�tMA_, NOTE: Under the provisions of Ch. 111, Section 31, of the G�neral Lavin of MA, hazardou�material 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 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: -Q v1, CJvtit Inspector: , Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I Date: 6 /z10 / 43 TOWN OF BARNSTABLE —r4s e.,o„- TOXIC AND HAZARDOUS MATERIALS N FORM nn NAME OF BUSINESS: J°(o�1 S I f yG�,L coo BUSINESS LOCATION: S�7_ 14,0 0015 INVENTORY MAILING ADDRESS: ,f4ou_ TOTAL AMOUNT- TELEPHONE NUMBER: S68 --7-7 1 - 5-9 R-7 - - 70S7 � ,F CONTACT PERSON: atK_ o�e a co EMERGENCY CONTACT TELEPHONE UMBER: MSDS2N SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: OALeag o.b+e4j vL_ ✓VIES Fire District: 56,,+t , avtel— lee-,D o K 6,4g_. CV ergs -"o e;rz&4e__s D,1I e ovtf, 44 etrl n►s 41av- &VJ- Or6t&A, 6 A -fe vu✓JlaA, Lcm_ Aa,,AJ? S So r V/oy Y"y �eua�a c7!-��: 1A.44' rv1►3 6 27 13 29(1Z_ Waste T �1VSo8771���7 Last shipment 6f hazardous waste: o Name of Hauler: Cyn©►/ -t �tQ4-4 r/eerz Destination: �+d,04 l�A-0V►,-, M{� Wets � 1 Waste Product: o, avt ,fc - �� hal— Licensed? No MA�002-3o3717 .f 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 '1 Lt Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive &NEW` 11 �USED�,-,4 too Cesspool cleaners obg. 2� t Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) Hydraulic fluid (including brake fluid) 361 b Refrigerants 3 Motor Oils Pesticides CrNEW lby USED 1-1 mo.� (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) 6 lubricants, gear oil ❑ NEW ❑ USED 2O 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 G� C✓� Zvli �WL� �75'I" All �r��S Laundry soil &stain removers (including bleach) w �-e 6hclrkl� tS 14krjii,,,c Qyt Spot removers&cleaning fluids (dry cleaners) a�s0(1 d-g qKpe ®46 ie(e a✓aj 1A ble__. Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials `oFIME roy 'Town of Barnstable Office:508-862-4644 Public Health Division Fax:508a90-6304 • BARMA�Bq 200 Main Street• Hyannis, MA 02601 1639. �prEOMP+a`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ROM Iod4 i Date: �$lD7/oaf Location/Mailing Address: , Contact Name/Phone: 0 -171-M7 Inventory Total Amount: <Sor) MSDS: D.kAz License#: M7 Tier II : 0 0 Labeling: Spill Plan:L{A Oil/WaterSeparator: ® Floor Drains: , Emergency Numbers: Storage Areas/Tanks: 7O ray is et � 0 Emergency/Containment Equipment: S Waste Generator ID: /`�V J _Waste Product: ��fv ni) Date&Amount of Last Shipment/Frequency: (57 SA(AA i Licensed Waste Hauler&Destination: 1`Ti n 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) V Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/REQOMM NDATIONS: 1 OWAke, 3911 S V S AD CAW �C 2� Inspector: Facility Representative. 1l/ WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee f7 187 THE COMMONWEALTH.OF MASSACHUSETTS $1oo.00 Town of Barnstable. Board of Health This is to Certify that Ron's. Truck Stop 52 Thornton Dr., 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 6/30/2010 unless sooner suspended or revoked. ---- -------- - ---------- -- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable ' Barnstable THE Regulatory Services Department °^ il1l-Art��ica i�rly BA" • Sr.48LE, Public Health Division 9�A ; 200 Main Street,Hyannis MA 02601 Tf�tr1A't A m 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO: �" �U. ~ `0ATE lO APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT , C� NAME OF ESTABLISHMENT 1. t� �ADDRESS�OF ESTABLISHMENTS' TELEPHONE NUMBER �`�J(•i/�l r �� 1,7. : ... `� •fr ' SOLE OWNER: V YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O'I ALL PARTNERS: z- 7a -w .� x M va fv �> IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION M FULL NAME AND HOME ADDRESS O PRESIDENT M Pt L TREASURER CLERK • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME'TELEPHONE # Q:\Hazmat\'Haz Ylat Application2008.DOC . t S M E A KEEPING YOU ORGANIZED No.103U 2m953L MADE IN USA GET ORGANIZED AT SIIlEA®.COM