HomeMy WebLinkAbout0138 THORNTON DRIVE - HAZMAT pS T\
rw'
l
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
1 � Mail To:
NAME OF BUSINESS: Co 61h `I oov Cd c• Board of Health
MAILING ADDRESS: / Town of Barnstable
TELEPHONE NUMBER: 7 2 f —ot 70 0 P.O. Box 534
CONTACT PERSON: Lo 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 tetaftg
- Please put a check beside each product that you store:
Antifreeze (for gasoline or coolant systems) Drain cleaners
Automatic transmission fluid Toilet cleaners
Engine and radiator flushes Cesspool cleaners
Hydraulic fluid (including brake fluid) Disinfectants
Motor oils/waste oils Road Salt (Halite)
Gasoline, Jet fuel Refrigerants
_ Diesel fuel, kerosene, 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) Wood preservatives (creosote)
Rustproofers Swimming pool chlorine
' Car wash detergents Lye or caustic soda
Car waxes and polishes _ Jewelry cleaners
Asphalt & roofing tar Leather dyes
Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
Paint & lacquer thinners PCB's
Paint & varnish removers, deglossers Other chlorinated hydrocarbons,
Paint brush cleaners (inc. carbon tetrachloride)
Floor & furniture strippers Any other products with "Poison" labels
Metal polishes (including chloroform, formaldehyde,
Laundry soil & stain removers hydrochloric acid, other acids)
(including bleach) Other products not listed which you feel may
Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Household cleansers, oven cleaners
White Copy-Health Department/ Canary Copy-Business
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTHK 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
COMPANY. (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS IaSS' ` ° �� 7.Miscellaneous
�� ITANTITIES AND STORAGE (IN=indoors; OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons 777 Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel Kerosene #2 (B)
Heavy Oils:
waste motor oil (C) 5a/�
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2. Water Supply
O Town Sewer „Public
On-site OPrivate
3. Indoor Floor Drains YES NO 4416
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 wella-A, '
Z�
O On-site system
a
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
2.
Person (s) Interviewed Inspector Date
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: elwV IS/,� `5'464 A UV0-y fI Board of Health
MAILING ADDRESS: / '� ib-r ' �''��'-�� W�.0-'y`3Town of Barnstable
TELEPHONE NUMBER: 771—/ 9Z1 P.O. Box 534
CONTACT PERSON: �,�� ,� Hyannis, MA 02601
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities total lin t 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 quantities totalling more than 50 gallons liquid
volume or 25 pounds dry weight. Please put a check beside each product that you store:
Antifreeze (for gasoline or coolant systems) Drain cleaners
—X Automatic transmission fluid _ Toilet cleaners
Engine and radiator flushes Cesspool cleaners
X _ Hydraulic fluid (including brake fluid) Disinfectants
C Motor oils/waste oils Road Salt (Halite)
Gasoline, Jet fuel _ Refrigerants
X Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides,
,— Other petroleum products: grease, lubricants rodenticides)
_K 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
X Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
C 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
_X Household cleansers, oven cleaners
White Copy- Health Department/ Canary Copy-Business
J-p^; r•. ..'�r..�r,L-:..:r•-i�,,,.v:�w�.�...
. t
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH r satisfactory 2.Printers
3.Auto Body Shops
Q unsatisfactory- 4.Manufacturers
.COMPANY CIA ,Y �'� 4 k,04-h ye,µ (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS /7Y Y6 a- ,Iw Class: 7.Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A) -
Diesel, Kerosene, #2 (B)
Heavy Oils: x
wastemotor oil"(C) ;
f new motor oil(C) "
0 ,.
transmission/hydraulic r �
' Synthetic Organics:
degreasers
Miscellaneous:
- t
1:z- , 1
Of
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2. Water Supply .✓ �, ? 44 r�- --f
0 Town Sewer O`Pubiic
O On-site OPrivate
3. Indoor Floor Drains YES NO
O Holding tank:MDC
O Catch basin/Dry well
O On sitesystem
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 Destination Waste Product •d
YES INO
2.
Pearson{s) Interviewed "" Inspector Date
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: ��� � Board of Health
MAILING ADDRESS: ,� fi rn � �4VnXqZtown of Barnstable
TELEPHONE NUMBER: / / . �� P.O. Box 534
CONTACT PERSON: � � ��!-�
Hyannis, MA 02601
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities totally, at any time, more than 50 gallons liquid volume or 25 pounds dry
t' weight? YES NO 2/
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 stor
Please put a check beside each product that you store:
Antifreeze (for gasoline or coolant systems) Drain cleaners
✓ Automatic transmission fluid Toilet cleaners
Engine and radiator flushes Cesspool cleaners
Hydraulic fluid (including brake fluid) Disinfectants
Motor oils/waste oils Road Salt (Halite)
Gasoline, Jet fuel L-"�_Refrigerants
Diesel fuel, erosen 2 heating oil Pesticides (insecticides, herbicides,
Other petroleum products: grease, lubricants rodenticides)
l--"-Degreasers for engines and metal Photochemicals (fixers and developers)
Degreasers for driveways & garages Printing ink
Battery acid (electrolyte) Wood preservatives (creosote)
v Rustproofers Swimming pool chlorine
C� Car wash detergents Lye or caustic soda
U Car waxes and polishes Jewelry cleaners
Asphalt & roofing tar Leather dyes
Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
Paint & lacquer thinners PCB's
Paint & varnish removers, deglossers Other chlorinated hydrocarbons,
Paint brush cleaners (inc. carbon tetrachloride)
Floor & furniture strippers Any other products with "Poison" labels
Metal polishes (including chloroform, formaldehyde,
Laundry soil & stain removers hydrochloric acid, other acids)
(including bleach) Other products not listed which you feel may
Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Household cleansers, oven cleaners
White Copy-Health Department/ Canary Copy-Business
• • CLASS: • Rep
satisfactory
3. • Body •.
satisfactory- 4.Manufacturers
r. "Orders") 5.Retail Stores
6.Fuel Suppliers
7.Miscellaneous
1 J? 1OIL
1 Case lots Drums Above Tanks Underground Tanks
4111
ONE 1-0.4110
e - awlps-4
MEN pw Nx4wn"10
SEENEENIM
01 • •
Mo-
aloe"
I 'I
ijiiii��Jj!
Y230.m"..dm�
i
Name of Hauler Destination Waste Product Licensed?
��`'
i
I/U5PFCTEO ;
i TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF FIRM: �� �' t� �"�����•-�l�-►c-:��.�, 6 c�l�,
MAILING ADDRESS: �,.a-� ���.? � �}�,1y��e�
IT,j,
TELEPHONE NUMBER: `771 -t q 9Eff-:1
CONTACT PERSON:
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 N0
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 quantities
totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put
a check beside each product that.you store:
Antifreeze (for gasline or coolant systems) Refrigerants
Automatic transmission fluid Pesticides (insecticides,
Engine and Radiator flushes herbicides,rodenticides)
Hydraulic fluid (including brake fluid) Photochemicals
tom' Motor oils/ :Yte-� Printing Ink
Gasoline, Jet fuel Wood preservatives
Diesel fuel, Kerosene, #2 heating oil
t--- (creosote)Other petroleum products: grease, Swimming Pool chlorine
lubricants Lye or caustic soda
Degreasers for engines and metal Jewelry cleaners
Degreasers for driveways & garages Leather dyes
Battery acid (electrolyte) Fertilizers (if stored
Rustproofers outdoors)
Car wash detergents PCB' s
Car waxes and polishes Other chlorinated hydro-
Asphalt & roofing tar carbons, (inc.carbon
Paints, varnishes, stains, dyes tetrachloride)
�-- Paint and lacquer thinners Any other products with
Paint & Varnish removers, deglossers "Poison" labels (including
Paint brush cleaners chloroform, formaldehyde,
Floor & Furniture strippers hydrochloric acid, other
Metal polishes acids)
Laundry soil & stain removers
Other products not listed
(including bleach)
which you feel may be
Spot removers & cleaning fluids
toxic or hazardous (please
(dry cleaners) RECEIVED
Other cleaningsolvents list. :
HEALTH DEFT.
Bug and tar removers TOWN OF BARNSTABLE
Household cleansers, oven cleaners
Drain cleaners
Toilet cleaners
Cesspool cleaners
Disinfectants MAY 2 0 19�1
Road Salt (Halite)
1 l
CJ� _U 5 Onl
In
16
�
�O
� � it
TOWN OF BARNSTABLE
BOARD OF HEALTH
CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET
FIRM l �gS51C coat Vyj " s
ADDRESS 1180 orAi on Dr.
Major types of materials: 1) B r reS rn - /14'2) g 3) �+
None O Ct'lor 4) 5) 6)
I. Description of material (s) use: Vq b ly ' SA1411
-Ad Cam
II. Storage (denote product by number listed above)
A. Containers
metal gla s paper plastic
cans,bottles,jars
drums,barrels
aboveground tanks
underground tanks 114Ut
bags,boxes r
open,loose,uncovered
inadequate labelling
B. Storage Facility Vor. # Remarks/Recommendations
1. Indoor
a) separato, contained room
b) stored in general work area
i) inadequate ventilation
ii) floor drains
iii) inadequate fire protection
2. Outdoor
a) uncovered, exposed to weather
b) pervious surface/catch basins
III. Disposal
A. Reclamation/Recycling unit
B. On-site disposal
1. Town sewer
2. Regular septic system
3. Separate holding tank
C. Off-site disposal
1. hauled by own firm
2. hired hauler
a) name of hauler
b) address or disposal site
Person(s) Interviewed — — — Inspector
Date
TOWN OF BA R N STA B L E COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
BOARD OF HEALTH -satisfactory 2. Printers
Auto
B
3. Auto Pod y Sho p
s
O unsatisfactory- 4. Manufacturers
COMPANY���+�S,c C a ' (see"Orders") 5. Retail Stores
oa= i0b kS 6. Fuel Suppliers.
ADDRESS Class: 7. Miscellaneous
QUAI TIES AND STORAGE (IN=indoors; OUT=outdoors)
MAJOR MATERIALS Case lots Drums AbpveTanks Underground Tanks
IN IDUT. IIN IOUT IN UT # zallons Agerest?
Fuels:
Gasoline, Jet Fuel (A)
,
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers `S_lne !,
Miscellaneous: t
DISPOSAL RECLANAT,ION REMARKS:
1. JSanitary Sewage 2. Water Supply
OTown 1'Sewer O Public `,
O On-site O Private "_r., I f�-�'�--��
_
3. Indoor Floor Drains: YES NO + I A" 1l„�
O Holding tank: MDC
O Catch basin/Dry well _
0 On-site system _
4. Outdoor Surface drains:YES NC �—
® Holding; tank: MDC �' �i 14
- w D (z
Catch basin/Dry well
On-site system
S. Waste Transporter "i�,� , j �U� � Licensed?
6w ofHauler- Destin tiW Xaste Product YES1 No
24
�i
/Bl. �Per'son(s) `Ifiret iewed'12 Inspector Date
r
TH�OMMONW L OF MAPS USETTS
B ARD OF HEALTH
NOTICE TO ABATE A NUISANCE
19
As Eupt oyouereby notified to remedy the conditions named blow within
24 hours of the service of this notice, according to Massachusetts
General Laws,Chapter III, Section 123:
1 '
�C� irti /7s
If at the expiration of time allowed these conditions have not been
remedied, such further action will be taken as the law requires and a
fine of$20.00 per day may be charged.
By Order of the Board of Health
Inspector
FORM 600 HOBBS&WARREN,INC. REVISED 1979
j
O.kIC ,kND :',.k7 il!L
NAME OF FIRM:
MAILING ADDRESS:
TELEPHONE NUMBER: j 7 _ 7 7_�5 _s_ Q3 G:7�
CONTACT PERSON: � ��
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 2S 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 quantities
totalling more than 50 gallons liquid volume or 25 -pounds dry weight. Please put
a check beside each product that you store:
Antifreeze (for gaslirie or coolant systems ) Refrigerants
Automatic transmission fluid Pesticides (insecticides,
Engine and Radiator -flushes herbicides,rodenticides) !
Hydraulic fluid (including brake fluid) Photochemicals
Motor oils/waste oils Printing InkI
Gasoline, Jet fuel Wood preservatives
Diesel fuel, Kerosene, #2 heating oil
(creosote)
Other petroleum products : grease, Swimming Pool chlorine
lubricants Lye or caustic soda
Degreasers for engines and metal Jewelry cleaners
Degreasers for driveways & garages Leather dyes ;
Battery acid (electrolyte) Fertilizers (if stored
Rustproof ers outdoors)
Car wash detergents PCB' s i
Car waxes and polishes Other chlorinated -hydro-
Asphalt & roofing tar carbons, (inc.carbon
Paints, varnishes, stains, .dyes tetrachloride) '
Paint and lacquer thinners Any other products with
Paint & Varnish removers, deglossers Paint brush cleaners "poison" labels (including
Floor & Furniture strippers chloroform, formaldehyde,hydrochloric acid, other
Metal polishes., acids) "
- Laundry soil & stain removers
(including bleach) . Other products not listed,.
g which you feel may be
Spot removers & .cleaning fluids
(dry cleaners ) toxic or hazardous (please
list) :
Other cleaning solvents
Bug and tar removers i
Household cleansers, oven cleaners
Drain cleaners
Toilet cleaners
Cesspool cleaners
Disinfectants
Road Salt (Halite)
] OWN OF BARNSTABL� .. . 2. Printers
�satisfacto.ry A Auto Body Shops
:,BOARD OF HEALTH ' 0unsatisfactory- 4. Manufacturers
see"Orders") S. Retall Stores
COMPANY ?i 1 - � ( 6. Fuel Suppliers
ti r Class• _ 7. Miscellaneous
ADDRESS � ��"� .._==
QUANTITIES AND STORAGE (I indoors; OUT=outdoor:
MATERIALS Case lots Drums AboveTanks U�nde:tground Tanks
MAJOR MA IN UT I 0 IN OUT
est
Fuels: '
Gasoline, Jet Fuel (A)
Diesel, Kerosene, N2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics: ti ` 4
degreasers
Miscellapeous:
DISPOSAL RECLAMATION REWAKS:
1. Sanitary Sewage 2. Water Supply
0 Town Sewer .Public _
On-site Private`
.3. Indoor Floor Drains: YES NO �+..._.._
Q Holding tank: MDC
OCatch basin/Dry well �_�-.�_. ._..._. ______............ ...___ _
0 On-site system
4. Outdoor Surface drains:YES NC
Q Holding. tank: MDC _
OCatch basin/Dry well �..------ ----- --
OOn-site system
S. Waste Transporter. ' _._ . Licensed?
f Hauler_ i)Petina inn : Waste Pra(it ct '
1 7%, f ,
$46
rson s I er,,�iewe Inspector Uate�
u ei �.
T
f OF BARNSTASL � i ' COMPLIANCE: CLASS: 1 hSarine,Gas Stations,Repair
•- 2 Printers
BOAR OF HEALTH O satisfactory 3. 'Auto Body Shops
`J nsatisfactbry_ 4. Manufacturers
COMPANY
t. }3 L j&-,•�, 141 i>� '� (see"Orders' S. Retail Stores
6. Fuel Suppliers
ADDRESS VY i0• LJci`_j 4�G r Class : 7. Miscellaneous
s
�� - �►P' QUAlNTI TI ES AND STORAGE (ILN=indoors; 0' T=..Utd0 ry MMIMIMMIlm`
V l l..G�uuv�
R �—_ Case lots Drums AbOveTanks Underground. Tanks
IN UT IN OUT IN UT # gallons A e fiest
Fuels:
Gasoline, Jet Fuel (A)
f !
k
Diesel, Kerosene, #2 (B)
Heavy Oils:
I
waste motor oil (C) 1
new motor oil (C)
> transmission/hydraulic
t _
Synthetic Organics:
i
degreasers
i
Miscellaneous: l I
- ___ ��� _ _._. _ .r..,�._. ..•_____,_ .ice- _-..�-r..� _.�..�___...{- - -._...
DTSPOSAL RECLA 'AT ION {{ -. H•__r ___ -.___..___
1....-Sanitary Sewage 2. eater Supply -
® Town Sewer Public
® On-site
0 Privates
I
3. Indoor Floor Drains: YES NO
® Holding tank: hiDC t `
Catch basin/Dry well
OOn-site system
_"4. Outdoor Surface drains:YES NO
0 Holdint tank: biDC ---=- --
4�
Catch -basin/Dry well
® On-site system
S. Waste Transporter , Lidensed?
Name of Hauler. Destination j a; to Product Y FS N 0
'Person Ts) Interviewed Inspector Date
`�r
C �j
ro � �_
�<
�;
�.
,;
�n
a
t
i
• ���.
a
. e � �
f �
t
i
T y v `
� ...
,�`� ..
- '+�
� � � '�, � _
i � �
s
u-.
VOWN OF BARNSTA 3LE 'COMPLIANCE: r arilie, as • a ions, epa .r
' Q sa'tisfact,ory '
2. -Printers
90AR D OF HEALT.Hi• • 3. Auto Body Shops
O unsatisfactory- 4. Manufacturers
(see"Orders") S. Retail Stores
COMPANY i m -� 6. Fuel Suppliers
ADDRESS Class: 7. Miscellaneous
QUAN 'ITIES AND STORAGE (IN=indocrs; OUT=outdoors)
MAJOR MATERIALS Case lots Drums AboveTanks Underground Tanks
IN PUTI IIN IOUT FIN OUT H gallons Aee rest?
Fuels:
Gasoline, Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil C r%
transmission/hydraulic
I ;
Synthetic Organics:
degreasers
i -
Miscellaneous:
DISPOSAL RECLAMATION• —REMARKS:-
1. Sanitary Sewage 2. Water Supply
own Sewer Pub lic
On-site Private
i
3. Indoor Floor Drains: YES NO�-
Q Holding tank: MDC
O Catch basin/Dry well U..,uC
On-site system
� -._------ --•--- ..-----•-----
4. Outdoor Surface drains:YES NO ✓� t� V
7
Q _Holding, tank: MDC
O Catch basin/Dry well
0 On-site system
S. Waste Transporter Licensed?
Name of Hauler_ Destination w�te Product '
J
z3 ei Person s)—Int.erviewed ` ..` Inspector Date
jOWN Or BARNSTABLE COldPLIANCE: CLASS: 1. Marine,Gas Stations, Repair
Q satisfactory 2. Printers
BOARD OF HEALTH 3. Auto Body Shops
1 . i unsatisfactory- 4. 'Manufact:urers „
COMPANY a (, � �2 (see"Orders' S. Retail Stores
J� oe,F,y. 6. Fuel Suppliers
%ADDRESSClass: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=i}:,docrs, CUT=out 630-fL.
'MAJOR MATERIALS Case lot - Drums AboveTanks Undergro.uad Tanks
IN tJUT I IN 011T IN POUT It & g2llons Age FFe
Fuels: j
Gasoline, jet Fuel (A)
I _
Di.PSel, Kerosene. #2 (B) I �-7 '5 ��-
p�
Heavy Oils- f
waste mo to� oil (C)
1 ,
new motor oil (C) I _
transmission/hydraulic f
Synthetic Organics:
I f
degreasers
'*;iscellaneous:
D i SPOSAL RECLA-MATIO v RENMARKS. --------
1. Sanitary Sewage 2. Water Supply
OTown Sewer O Public I _
On-site Private
3. Indoor Floor Drains: YES NO
Holding tank: MDC
0 Catch basin/Dry well ( -- --__-_-- -------.------- __-- --_—__
`-'-
Or,-site system � �
4. Outdoor Surface drains:YES NO
- 0 Hc:l d i.n b tan}:: Ti .C I
® Catch basin/Dry well, is�;.e,.�./lLu� �(� �� k
q�
On-site systemLk"T UL t�.n
- --
S. Waste Transporter ' ° Licensed?
Name of Hauler haste Prndiict.
1. AJAI
ql' person(s} interviewed Inspector Date
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
N.�IE OF�FIRM:
MAILING ADDRESS: Box IlR-Z_
TELEPHONE NUMBER:
CONTACT PERSON:
Does your- firm--store-and of---the=t-uxi=e=-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
i
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 : /410
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 quantities
totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put
i
a check beside each product that.you store: !
Antifreeze (for gasline or coolant systems) Refrigerants
Automatic transmission fluid Pesticides (insecticides,
Engine and Radiator flushes herbicides,rodenticides)
Hydraulic fluid (including brake fluid) Photochemicals
Motor oils/waste oils Printing Ink
Gasoline, Jet fuel Wood preservatives
Diesel fuel, Kerosene, #2 heating oil (creosote)
Other petroleum products: grease,
lubricants Swimming Pool chlorine
Lye or caustic soda
' ;,1 Degreasers for engines and metal I
Degreasers for driveways & garages Jewelry cleaners
Leather dyes
Battery acid (electrolyte) Fertilizers (if stored
Rustproofers i
detergents
outdoors)
Car wash deter � .
g PCB' s
Car waxes and polishes Other chlorinated hydro-
Asphalt & roofing tar carbons, (inc.carbon
Paints, varnishes, stains, dyes tetrachloride)
Paint and lacquer thinners Any other products with
Paint & Varnish removers, deglossers "Poison" labels (including
Paint brush cleaners chloroform, formaldehyde,
Floor & Furniture strippers hydrochloric acid, other
Metal polishes acids)
Laundry soil & stain removers Other products not listed
(including bleach) which you feel may be
Spot removers & cleaning fluids toxic or hazardous (please
(dry cleaners )
Other cleaning solvents list.k;� E C E I V E D
Bug and tar removers i `"' T`' nGPT
Household cleansers, oven cleaners TOWN OF BARNSTABLE
Drain cleaners
Toilet cleaners '` HOOM
Cesspool cleaners j G:'4p _
Disinfectants f' 4, ;aie� �•� 1981
Road Salt (Halite) �� Mass. ,02630 MAY 4
3 -2148
TOWN OF BARNSTABLE
BOARD OF HEALTH
CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET
F I RM GQ
AflDRE-S�,_..
Major types of materials: 1) 2) 3)
4) lAk S) 6)
I. Description of material(s) use:
II. Storage (denote product by number/listed. above)
A. Containers etal glass paper plastic
cans,bottles,jars
i !� zze
` t drums,barrels / �t
aboveground tanks
underground tanks` �+
bags,boxes
open,loose,uncovered
inadequate labelling
B. Storage Facility ✓or.# Remarks/Recommendations
1. Indoor
a)' separatl!, contained room /.
b) `,stored in general work .area
inadequate ventilation-
_
ii):.floor drains " let
AAJ
i )= inadequate fire- protection
2. Outdoor .
a) uncovered, exposed to weather _
H) pervious.:surface/.&atthi .Basins
III. Disposal- .
A. Reclamation/Recycling unit
B. On-site disposal
1. Town sewer
r
2. Regular septic system
3. Separate holding tank
C. Off-site disposal
1. hauled by own firm
2. hired hauler
a) name of hauler
b) address or disposal site
- - - -
Person(s) Interviewed � +-•/ Inspector
Date Lv1 { -
- a
®SENDER: Complete items 1,2,3 and 4.
Put your address in the"RE"fuRN TO"space on the
reverse side.Failure to do this will prevent iWs ward from
being returned to you:`9'he return receipt fee will provide
you the name of the parson delivered to and the date of
delivery. F.r;�dditio&e1 fees the following services are
available.Consult postmaster for fees and check boxles;`
for service(s)requested.
A
�. }X Show to whore,date and address of delivery.
2 ❑ Restricted Delivery
n 3 Article Addressed to
%-Q,v„ ,o I An A' a �
4 Type of Service Article Number ,,
El Fiegistered ❑ Insured p 5Qa qi�4 �G
,E Certified ❑ COD
❑ Express Mail
Always obtain signature of addressee or agent and
DATE DELIVERED.
5 Signat to— Addressee
X
6 Sibnature - Agent
vl
X
13 7 Date of Deliver
8 Addressee's Add less(ONLY i requeste a ee pR
n
,
i
i
UNITED STATES PO 5Efthh
OFFICIAL BUSINFSS
SENDER INSTRUCTIONS,
Print your name,address,and ZIP Code In he s®.,
space below.
• Complete items 1,2,3,and 4 on the reverse.
® Attach t0 front of article If space permits, PENALTY FOR FRIVATE
otherwise affix to back of article. USE.$301)
• Endorse article"Return Receipt Requested"
adjacent to number. � j 2
FiETO0 C zv�C� "
TO
2 ( ame of Sender)
U'n- SA-. ,
(No.and Street,Apt,Suite,P.O.Box or R.D.N 1.)
4 A_• O aHo f
(City,Sthte,and ZIP Code)
P 522 444 186
RECEIPT FbR CERTIFIED MAIL
NO IN COVERAGE PROVIDED
NOT FOA'INTERNATIONAL MAIL
(See Reverse)
^ Sent to. Mc�
t411 Q' 1 "I
a Street and No.`a "�
1(1$ �
C P.O.,State nd ZIP Cod@
aM MA
.
u�1A.oa�38
c7 Postage $
V)
* Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to whom and Date Delivered
c4 Return receipt showing to whom,
o, Date,and Address of Delivery
T
TOTAL Postage and Fees $
U.
Postmark or Date (�
E
U.
rn
a
J'
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, 1
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front)
1. If you want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article
leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier.
(no extra charge)
i
2. If ypu do not want this receipt postmarked,stick the gummed stub on the left portion of the address side of the
articlo,date,detach and retain the receipt,and mail the article.
3. If you want a return receipt,write"the certified mail number and your name and address on a return receipt card,
Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix
to back of article. Endorse front of artile RETURN RECEIPT REQUESTED adjacent to the number.
1 1
4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse
RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is re-
quested,check the applicable blocks in item 1 of Form 3811.
i 6.Save this receipt and present it if you make inquiry.
{ � ,.y •t!A r ° �Y e ,y' itr: 1' X r; x
t �.t,r. '. .: F ;+'•+` " .r n �'w �` C'tx,a ry '�' 1� y 8T"�n`'. y� f`.7 1�`F ysska
a � - + i r t: � .`� tS t w T. � t A-y, 3 r FI n � A 'r y,w. ���.4 1 a�V� � `�f r•'},ar'� '$T f v -.r'
- x •;l 5 w 'r3 4 a`+, J. F. ,JP i�. [ t4T�'� .�•.4r+ 9 ,.-xtkt *r r.lw �. 1'ti kl n ♦. y t ,�. -
5y+' f f S.� �� `.ro. a .j. C.ty� , d ^,}4y li ✓ � i"{! :. �',_ F4 `ti+.fe � +�� Y': � + r� , t ra.1. «.
°� s _; .• ♦ r' f<• .. •t.3 {. ° t P�-"st:•"f } r ,! y ! w3 i• �1.� �'.,� ..+t �a �1 y�e�,`"� ',
e t •s S i �e r - -� ° �, - e A u� 1 f, °K} � '�: dd _e 4,
�< .°� ^r 4.. r • 4 r tti� f .� e� Y:�°�� �"{ r+� {«tT a,r��� k�ya•R�it: t �f � 'r •i a �,.
4r46 r--Ira r✓Li � -.n r l ��3./d } � . ya,.•
e.. ,+r � +, �� err .. ti• - � '• t' - sr a x {'•,rs r t r- -.'r,"±�.,•',',t kr .� r`a? s 7 t,.�= t s'!'t �t 3�'..
All
d ° t.•4 �s r• "��4 x �.,•0. a ..s ., � ! t ,,.'.0 a ,, ,} ♦tk�- . y, v Y y ^t4 t "'iy;�'�P .:• a €,:i.
t-
*�; r, ` r a y i-r'S .�-' f: ..-t �3:�_} .•� � s ,Y "' °i t-a� :! � +��p +%. � Arta :� a..A o�
v October 28 1985 • Tr' f 1 e p tFn 6 k t ;{.r 7 r fft r arL
f . r• 1 4-J.
, -^ >' G3 °M•a S.< i c. .� 'P;.°+ t '. v f�+ y ,� y .• r
d`. � r,<F �Z r r2r !r w'"T`-,x •� k T u.. rS- a s,", e r w a
T is r i ♦ -. ,. 3e °ta t �Sr:rs F',` +�, �,,� .,.cFt. .z i` t � • .0
T 't { . xa f A ` x! '� F� 1.,i { by K c ■+ t d <,r,� - f 4
t .b i- z�a r• �, '+,ay'
{;; Mr.` Gerald P. McCarthy 's'i
° s �f
t 'r .. . • y,{ .yt, ?'3. r r{ °� { s 'ti'", •{ zt• "' 7 f '�. �n '_ y
12'Thoma6 COUIt ' ram= t , 4 " ,;y{Yy 4.+ w• i r t ,ti.
s M a 4 si*
*� Dennis MA: 02,63g ' - f. rfc r" .,
r• •~` + a •. n+r�.'• r ••2 I. t�
o `. - ° c;r 6R ` ai..]-. z..•+ _!, a•�, � �i.tT ,.= k °` a d•• ;. l"r. a �d i` '`.;
°.�SECOND7NO.TICS -TOs ABA TE=,VIOLATIONS 'OF 310 .CMR.30:100,'`IDENTIFICATION 'AND
•` "LISTING'! OF. HAZARDOUS: WASTE„" ANI� ARTICLE,-:2T:`,CONTRQLf .OFx<,TQXIC: AND
HAZARDOUS MATERIAL,OF .THE TOWN OF• BARNSTABLE BY LAWS1=:'
v yy`Ly' i s i,�'# w ;•d µy �, cs, � . �,t a-.. �� - s': '• 71 r. •f ��; � 's.
yr• ?�; 'a .•� 'a •. � r � .. � �.. r � a,. - :F? a 1: '• t' to
s T1. he+"..property,.owned bye?you, liste4 .d 'as,;Parcel'010, on.-Assessor's{ Map,No. 296 locat 1.ed�dn
aThorntonDrivet Hyannis;' as re=inspecteduby"Thomas McKean, Heaith lnspector':for
Town of,''Barnstable",'on-` September, ,5; ,October Y6;'and. October 29; 1955. The following
3� violations:.of• 310, CMR 30.160 �`Identif cation 'and"Listing of Hazardous Waste and Article' `
Cont of<of tToxic�;and 'HazardousMaterial, of,'the Town""'of;Barnsttable By-Laws,.were
P i .. L t � }
observed:., #P` . �• i 'n' r F r >; {
..,�
Y +l•r� eft. �r .a f �!.{�^ a .r`, <
y Four (4) 55 tigallon 'unlabeled plastic ?barrels, full =of a hardened 'unidentified;chemical
f are located•outside; and-are'not p.' ected, f the`'elements One.(1) of these.-barrels
' . -
i =s °•is not covered which,presents an immediate potential threatto thekerivironment
r f !T n
;'`+ t i s 't,. +�" .t' s.a.t eFl E . 1. e ...,+, ��.?` � °• ex •1F rr�.hc V `• �..Tw.: `
T��'Y:� -r •`�,� ,'. �`. � 1y x: � rtia • +M �+.�, '* _�. r .`_'' J��':*�a i r �' P;j s k a
t �� {These ' unlabelede}plastics barrels' of rounknowin .chemical's' must 'be removed by. a ,licensed,"
i" ` hazardous waste transporter within•twenty-Pour;(24) >hours:of receipt ofthis+notice:E '°The t :d '
Board of;Health must receive>written'certificationfrom°the transporter tlatthese materials r *'»
't. were disposed of at:a'licensed hazardous wasterdisposalwsrte = �' i '•; w '
tl`'1tP+
You ma a nest a"hearingabefore.the.`Boatd oP PHealth.-if,wr tten•rpetition requesting same'
{1 •` yr •,.' '• A P.r � r '� y .-. T� f }h k ♦ 4 Y• r ... r. � < t r f. •.is received,within.-seven (7) days; after receipt of: this order, however, the order must be. w
complied with within the,t me frame `specified ;' ' e
at • s..l�9 �::�°'• 13' t.3�a.;:i Y ,�, � k" t _ a sf �' .� � '� r ✓'. a,2 ay't 1 `a� a r "5
� vt �� r• i Gt ' wt ' "n 'Z h •. '.. r � a ••.� 7� ,.r ��" 1.: •° .. ; * �;
Non-compliance=may result; in. a',fine'of sup,ao $500' ,Each days-failure•too comply with,tan:, 'd i�L 7,
order shall constitute"a.separate violation: ftYou,are-also subject to':a;ticket,dtat16n4 for �
each day'',eiolations are.$bserved.� Therer,isf a .$25:00 fine for:.egch'ticket ssued Tickets
wiwbe°rissued daily until-the,violations are corrected
A r i 'n �1tY I
f„M•}.. r . 4 • '., + 4:�Y J ! t N «, Y � Y f.f n 7 a.• a A� 4 i
k ';:a 1! -.! F f .• a
PER`ORDER OF;THE_BOARD OF`HEALTH
ds t _ „y R'. �.t y T y.i• a i .t t `'f' �Y:
e �� Ys:;:y .s .f• .i,'. a S , ,.'4 i y":.'� +i'' � z .. • f ' tr '�- �f'
!.
i 9 „i x..'• jL, +;"•- t 9 fF , . it s xa.. _
•, r a r,
+.-s�a.1�v. ,. 7
y x i• •k x n.� f i 4 9 y yf: {,CrC r r`. a St
Thomas A.:McKeanf.- . ,;, •:'� �f t t s .alt _ m w r,e.�,, '':f'� •" f r ° ! k• °t r`.r 4+ rF n, G
HealthAspector
-BOARD��F •.�� � ,. 'r,,w fr �„ ,, .,�,��.1> � 4 �,�,�' f-� "; , � .�'_
HEALTH ;
�. � �u �;t a 7 �j w„ jpr.!. n t:. + '�.- �. •, v'rr f of.r7 x `R'•. t i_t S e r' t .r a t
TOWN OF BAR'NSTABLE�F . �+°
♦ a �� af. p r +' t 1 r'" 8 ir' Y.•v •d + t r,. t h f f+ v i 1~ �'r ,.4 7
«} + -9n1 p i'.. x" � r _ i�f r r t.,'t �''4�F.'"+ /s,.y� v .�_ i ,; •,� 'r*i r _, '
f - tt � r •..sy r C tii f ° ` "•� •.'C �r �- '• ;''tom!
1 •• r r C i , t ♦r'° t . ai C I�; TAbi mm , 7 .., ,, r•
ft += �cc` 'BOard,oP�Selectmen'� a '`` �`� s;r`"`� :�'l:�tt�'-� . � .{`�, : ,.,� �=, '�, ;t,t/�rAA7�X`Wit, .� s *t+r� �� •
?Water.Quality,_,
' iff.`Ru"ssell�Conti,
,r..
.•.d .tr' r �,. .,Fb `� E.. M ,St r• d..4 '#„n1°'%'."{ •�', ., +"Ns '1 .X
ret .= Yy:. t 9' ; E F m .,j,t,, a�'f a'�'.t... i +s ,t ,r- ..>• t t
!'t t r,( ,`Y a .r w* .Y Yet d,,, tw �y7,.s• r' },et... +, < i! •,{.� .•t a Ff 4t
- ,4'i. �.y Y3 fit r ,.lr '.ra{- r-.v i`':il.} yE •et• -♦. • } L t q � •
c t e. •� t t
�� f +Ya.a wk.wy.r..i4. '-� ° .� - ♦,; 't ° ., by: T• § �:.i�C�• •
m
®SENDER. Complete items 1,2,3 and A.
$ Put your address in the"RETURN TO"space on tha
3 reverse side.Failure to dU this will prevent this card from
41 being returned to you.The return receipt fee will provide
0—. you the name the person delivered to and the date of
c_ delivery. For additional fees the following services are
e available.Consult postmaster for fees and check box(es)
-t for service(s)requested.
Wr.xw— Show to whom,date and address of delivery.
'P' 2. ❑ Restricted Delivery
V
00
3 Article Addressed to
Mr. Gerald P. McCarthy
12 Thomas Court
DENNIS MA 02638
4 Type of Service Article Number
❑ Registered ❑ Insured P 522 444 152
U Certified ❑ COD
❑ Express Mail
Always obtain signature of addresseeQagent and
DATE DELIVERED.
5 Signature— Addressee
3 X
m 6. ignatur9 - Agent
A X
MI 7. Date ofiv
C
Z 8 .Addressee's Address(ONLY t requeste a ee pa
gj—
Im
'n
m
v
J
J
UNITED STATES POSMOR
OFFICIAL BUSINOSS PM
SENDERINSiRUCTtONS 7ti
Print your name,address,and Z1R�osiq try the ---�� ., �. _tLILM"
space below.
on the reverse.
• AttadlP Oi art da If space permits, PENALTY FOR PRIVATE
otherwbe affbt to bads If article. USE,$301)
• Endorse article"Tatum Receipt Requested"
adlecent to number.
RETURN
TO BOARD OF HEALTH - TOWN OF i
BARNSTABLE (Name of Sender)
P. O. AN..a treet,Apt,Suite,P.O.Box or R.D.N;�
Ox
' I
HYANNIS MA(16tj6trtj. VIP Code)
I
iIi
P 5'22 444 152
RECEIPT,-FOR CERTIFIED MAIL
t
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
Sent to
Mr. Gerald P- Mrrarthy
Street and No:
m
a
P.O.,State and ZIP Code
O
d
o Postage $
y
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to whom and Date Delivered
a Return receipt showing to whom,
Date,and Address of Delivery
T
m TOTAL Postage and Fees $ 1.67
U.
Postmark or Date
Mailed 8/23/85
U.
STICK POSTAGE STAMPS TO ARTICLE TO 111111111111111 POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front)
1 rlf you w&nt this receipt postmarked,stick the gummed stub on the left portion of the address side of the article
leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. l
(no extra;charge)
2. If you donot want this receipt postmarked,stick tie gummed stub on the left portion of the address side of the
article,date,detach and retain the receipt,and mail the article. i
3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,
Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix
to back of article. Endorse front of artile RETURN RECEIPT,REQUESTED adjacent to the number.
1
_4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse
RESTRICTED DELIVERY on the front of the article.
6. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is re-
quested,check the applicable blocks in item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry.
�.:
i�nm��'�r�, �,L�S �l�lrr�
-1-•�--�Z.rae.�n dCituz f ��u� -�1' n��+nw
rr�� �. .fr__ _ .
s-
,...
�u