HomeMy WebLinkAbout0080 THORNTON DRIVE - Health (2) 80 Thornton Dr.;o ;�5
—VIERAS AUTO RE
bw
—�A=oz��--•ova�Td �
o
1.
e
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: t1l '40 7z-) �f Mail To:
BUSINESS LOCATION: 7®, 7;�vA 'c,�_z)l /z1j/ AIA Board of Health
Town of Barnstable
MAILING ADDRESS: ae ?r✓ P.O. Box 534
TELEPHONE NUMBER: _ VP — 0 /�II Hyannis, MA 02601
CONTACT PERSON: _ i2• 7�i�'Cz1o'l
EMERGENCY CONTACT TELEPHONE NUMBER: 3 ?-R q
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities to (ling, 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 character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store:
uan ti
'ty/C Quantity/Case
00
Antifreeze (for gasoline or coolant systems) Drain cleaners r
G�
Ut' automatic transmission fluid Toilet cleaners `" v
Engine and radiator flushes <-'� rCesspool cleaners 0 166
Hydraulic fluid (including brake fluid) < Disinfectants
�,/""IVlotor oils/waste oils -----Road Salt (Halite)
Gasoline, Jet fuel --Refrigerants
. l Diesel fuel, kerosene, #2 heating oil pesticides (insecticides, herbicides,
Other petroleum products: grease, lubricants rodenticides)
Degreasers for engines and metal ,-----Photochemicals (fixers and developers)
Degreasers for driveways & garages �Printing ink
Battery acid (electrolyte) >ood preservatives (creosote)
---�- Rustproofers imming pool chlorine
Car wash detergents Lye or caustic soda
Car waxes and polishesJewelry cleaners
.Asphalt & roofing tar � �Leather dyes
Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
Paint.�' alnt & lacquer thinners PCB's
& varnish removers, dehydrocarbons,lossers Other chlorinated
- g �
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)
Sncluding
pof removers & cleaning fl i bleach) I Other products not listed which you feel may
fluids ho toxic or hazardous (please list):
_(dry cleaners) r
Other cleaning solvents Q '
and tar removers
Household cleansers, oven cleaners
I
i
White Copy- Health Department/ Canary Copy-Business
rno M s0V
� 20 iS
TOWN OF BARNSTABLEjsati PLIANCE: CLASS: 1.Marine,Gas Stations,Repair
factory 2.Printers
BOARD OF HEALTH3.Auto Body Shops
tisfactory- 4.Manufacturers
VI
"Orders") 5.Retail Stores
COMPANY / �-+�V /` 6.Fuel Suppliers
ADDRESS f Class: 7.Miscellaneous
/0%//V,� QUANTITIES AND STORAGE (IN= indoors;OUT-outdoors)
MAJOR MATERLS Case lots 1 ,• _ ,
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
Synthetic Organics:
degreasers
Miscellaneous:
YC,04 /fA V
DISPOSAL/RECLAMATION REMARKS:IarC1.
/Sanitary Sewage ! . ater Supply �PAOL4 C, U o
Town Sewer �ublic S I D6 0 6,
On-site QPrivate
3. Indoor Floor Drains YES N0X ,
O Holding tank: MDC tJ�
O Catch basin/Dry well SM 1, C JN I-r ski I iY
(�`r
O On-site system LID V l(, /Za �
4. Outdoor Surface drains:YES NO ORDER /� �/(�� GA � /
OF-
0 Holding tank:MDCGS
O Catch basin/Dry well
' O On-site system - �
5. Waste Transporter
Name of Hauler Destination Waste Product
2. C/
o •�
er s Interviewed Ins ec