HomeMy WebLinkAbout0053 THORNTON DRIVE - HAZMAT �,n
TOWN OF BARNSTABL- E )'CONPIAIANCE: CLASS: 1. Marine,Gas Stations,Repai.r
BO RD OF HEALTH O $" 7sgaC 3. Au z• Autoo Body
Shops
s
4. Manufacturers
nsatisfactory-
COMPANXc e�� �� "' �t �I (see"Orders") Retail Stores
44
Fuel Suppliers
AqD,RES ,', ,�; �, Q , Class: 7. Miscellaneous
1-_q f t•. ()uY
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors)
Case lots Drums AbOveTanks Undetground Tanks
MAJOR MATERIALS"� "'' IN IDUT IIN IOUT IN UT # & gallonserest?
Fuels:
Gasoline, Jet Fuel (A) -�
P
Diesel, Kerosene, #2 •(B)
Heavy Oils: f
waste motor oil (C)
new motor oil (C)
transmission/hydraulic —
Synthetic Organics:
K
degreasers Z
CU CND
'` "j i
o!J C'11'`' r
0�� __i'kte"OUS4 L .A< &P
g �
DISPOSAL RECLAMATION REMARKS o 1 -IQ)
1. Sanitary Sewage .Water Supply
OTown Sewer F 0 .public !
On-site Pr* to
c
3. Indoor Floor Drains: YES N0�-
O Holding tank: MDC
Catch basin/Dry well
O
On-site system f j'dw>
4. Outdoor Surface drains:YES NC j�Q� 6_6, q,uA hk+j&�, 17 J
O Holding tank: MDC A !
OCatch basin/Dry well . _... __ _ �_ n rir.
On-site system
V
S. Waste Transporter ` + - Licensed?
Name of Hauler. t Destination WaSto Erodu
1.
LAI"
12
23 81 Person(s) InterviewedInspector Dat �
rY Y 1 V��TRNSI W1� ' .r.ttrM C :—""�"" CCfc�° .� f- Fjat svir;ud_s .3�aciu,ty;�.r�,a,.,
atisfactory � ! ,
2. Printers
BOARD OF HEALTH 3. Auto Body Shops
{ unsatisfactory- 4. Manufacturers
COMPANY (see"Orders") S. Retail Stores
6. Fuel Suppliers
ADDRESS ram- '
' Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoor
,f�t' W1/t/`✓� Case lots Drums AbOveTanks Underground Tanks
MAJOR MATERIALS iJ
It IN OUT IN 10[ffIN OUT N 6 p2llonse Test
Fuels:/
Gasoline:,. ;Jet Fuel,"(A)
Diesel~{Kexosene k2 (B)
Heavy Oils:"
waste motor oil (Q)
new motor oil (C) 7.
transmissio Aydrauli , 1
Synthetic Organics:
de reasE s �
v
Miscellaneous:
Ft I
DISPOSAL/R. CLAMATION REMI.RKS: z.
1. Sanitary Sewage 2. Wate Supply a
O Town Sewer ubli.c __V
�r--
on-site Q Private
3.. Indoor Floor- Drains: YES NO
O Holding tank: MDC
0 Catch basin/Dry well —
On-site system
4. Outdoor.Surface drains:YES NO_ _
0 Holding tank: MDC
O Catch basin/Dry well
0 On-site system
S. 'Waste Transporter Licensed?
Name of Hauler_ _,.stination j rite Product
G1.
r <' A
�t ?`y
12 2if r o s nt.e iewed ri
)) Da e
TOWN OF BARNSTALE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
O satisfactory 2• Printers
BOARD OF HEALTH 3. Auto Body Shops
Ounsatisfactory- 4. Manufacturers
COMPANY l►'�t1U`� ty�! .. (see"Orders-) S. Retail Stores
6. Fuel Suppliers
ADDRESS Pr' ! �lN ,1'0_1 Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors)
MAJOR MATERIALS Case lots Drums AbdveTanks Undetground Tanks
IN 10UT IIN IOUT ' INIOUT # gallons Age rest?
Fue Ls::----•---�
Gasoline, Jet Fuel (A) 1
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C) !
new motor oil (C)
trap ss /hydraulic
I,/
Synthetic Organics: o
degreasers
Miscellaneous:
YICU".)
LM
DISPOSAL RECLAMATION REMARKS:
1. Sanitary Sewage 2, Water S y
OTown Sewer Public
OOn-site O Private
1 �
3. Indoor Floor Drains: YES L'/
Q?Holding tank: MDC _ `��.^c°t� > M - ti . 4_t,,,•.,
O Catch basin/Dry well �' f�',� �� � �CYf r .�_{17 '1\
On-site system r f* �. _ _ '
4. Outdoor Surface drains:YES NC 1\
I r
Holding tank: .MDC" >1
Catch bas ry wel
l
O
On site system
S. Waste Tr, nsporter "t `' � Licensed?
Nave of H aler stina ion Waste Product YFS NO
l
81 Person s Interviewed Inspector Date
BL �COMPLI'ANCE: CLASS: `I,r Marine,Gas Stations.Repair
OWN OF BARNSTi
a- satisfactory. 2 . Printers
BOARD OF HEALTH , 3. • Auto Body Shops
Qunsatisfactory- 4. Manufacturers
OMPANYt C A W> (see"Orders") 5. Retail Stores
yy� f� 6. Fuel Suppliers
DDRESS i { � is x� � Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indocrs; OUT=outdoors)
�,IOR MATERIALS Case lots Drums AbdveTanks Underground Tanks '
IN OUT ' IN OUT IN IOUT R e e T
Fuels: d
Gasoline, Jet FuelIV
(A)
Diesel, Kerosene, 82 (B)
Heavy Oils:
waste motor oil
new motor oil �(�)
transmiss>1hydraulc
Synthetic ;Organics
degreasers'.
Miscellaneous:
;POSAL RECLAMJITION REW,RKS:
1. Sanitary Sewage. 2. Water Supply
Town Sewer -P
public
OOn-site ` =`
Q Private
.. .Indoor Floor Drains: YES ` t. NO
O Holding tank: MDC ��•-� r
OCatch basin/Dry well'
O On-site system lEiLS
. Outdoor Surface drains:YES . NG
Q Holding• tank: MDC
O Catch basin/Dry well --
OOn-site system
. .Waste Transporter w • Licensed?
amp, of Hauler Dectinatinn }tllst_ FPrwodurtAA YES NO
iillv_
s ea Pers h s° lnt.erviewe' Inspector a e '
-
TOWN OF BARNSTABLE-, LUMPLI
satisfactory Printers
3. Auto Body Shops
BOARD OF HEALTH!/ " 4. ' Manufacturers P
0 unsatisfactory- S. Retail Stores .
A-v i�-r - (see"Orders")
COMPANY b 6. Fuel Suppliers
ADDRESS 4 Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoor!
Case lots Drums AboveTanks Underground Tanks
MAJOR MATERIALS IIN JOUT IIN IOUT IN IOUT N 6 gellons Ape irest
Fuels:
Gasoline, Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
_40
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreascrs
Miscellaneous:
DISPOSAL RECLAMATION R&WI,RKS:
1. Sanitary Sewage 2. Wat r Supply
0 Town Sewer Public
I
-0,On-site e Priva
3. Iddoor Floor Drains: YES .0yiva
0 Holding tank:. MDC_
O Catch basin/Dry well
0 On-site system ORDERS:
-. 4. Outdoor Surface drains*.YES_N6�
O HoldinL- tank: MDC O Catch basin/Dry well
Con-site system
S.. Waste Transporter Licensed?
Name of Hauler- Destinati -Waste Prod Uct YES NO
le
rson(s)
U 23 81 inspector Date
n
�n'}�.r'v,�+^'Sd•�:a�..-w'+"'•.aT•-...-..:u..�r-d'+Fie"trr^*-.=�'.r*4�Ynr"^r`$� '.''Aa7Fc.rgC'u''.r''"�...r y�"�-tia„��'or "'\t""M'�`r�"'�i�1.iy' t "T"''�"'y�'�i.',ryyiZ,.'` '�",y�e'•``;c�,�'^rr"�„�..+5-,...:^�
s
4 '
TOWN OF-BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
2.Printers
BOARD OF HEALTH o satisfactory 3.Auto Body Shops
O unsatisfactory- 'e Manufacturers
COMPANY X0A,41 (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS 3/ alkZ w1� , T Class: F 7.Miscellaneous
,4A,Or QU O ANTITIES AND STORAGE (IN_indoors;OUT-outdoors)
MAJR MATERIALSCase lots Drums Above Tanks
' Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A) "-
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil(C)
transmission/hydraulic Q 41
Y
Synthetic Organics:
degreasers
.4-4 f,44r
(Miscellaneous:
gl
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer rr`Public
(Von-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 V1 ORDERS:
O Holding tank: MDC '�/i`!t®it.�+
.O Catch basin/Dry well ,
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
_ YES NO
2. J �/
/W y a ley
Person`(sN-i tery ewed— "'` Inspector r Date !
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: y' Board of Health
MAILING ADDRESS: Town of Barnstable
TELEPHONE NUMBER: Z/,* P.O. Box 534
CONTACT PERSON: �1 �` s Hyannis, MA 02601
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry
weight? YES NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the
enclosed envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site other than your
mailing address:
ADDRESS:
TELEPHONE:
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous
characteristics and must be registered when stored in id
lease put a check beside each product that you store:
Antifreeze (for gasoline or coolant systems) Drain cleaners
f' Automatic transmission fluid Toilet cleaners
Engine and radiator flushes Cesspool cleaners
Hydraulic fluid (including brake fluid) Disinfectants
_V Motor oils/wa o'Is Road Salt (Halite)
Gasoline, Jet fuel Refrigerants
Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides,
VOther 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
V- Paints, s Fertilizers (if stored outdoors)
Paint & lacquer thinners PCB's
Paint &varnish removers, deglossers Other chlorinated hydrocarbons,
Paint brush cleaners (inc. carbon tetrachloride)
Floor & furniture strippers Any other products with "Poison" labels
Metal polishes (including chloroform, formaldehyde,
Laundry soil & stain removers hydrochloric acid, other acids)
(including bleach) Other products not listed which you feel may
Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Household cleansers, oven cleaners
White Copy-Health Department/ Canary Copy-Business
TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
KO unsatisfactory- 4.Manufacturers
COMPANY A-,IAI V. H �` (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS / f3 lass' 7.Miscellaneous
iz!u��&TITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons 77 Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils: ,
waste motor oil (C)
new motor oil (C) f v
transmission/h�c J
Synthetic Organics:
degreasers
Miscellaneous:
V
Oil
2
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply - v
O Town Sew ublic
Ile U
O On-site/�f fVPrivate
3. Indoor Floor Drains YES N0JZ!� .
O Holding tank:MDC
O Catch basin/Dry well r
O On-site system
4. Outdoor Surface drains:YES N0_�/ ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Destination Waste ProductLicensed?�
2.
person (s) Infervie fted Inspector Date