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HomeMy WebLinkAbout0178 THORNTON DRIVE - HAZMATFIT? IkaHon a�---v2,, . ,TOWN OF BARNSTABLE Ch 2. Printers i 141 satisfactory 3. Auto Body Shops -CARD OF HEALTH Qunsatisfactory- 4.' Manufacturers 4h u (see"Orders'l 5. Retail Stores COMPANYrl 6. Fuel Suppliers `Ti4y Class: F 7. Miscellaneous ADDRESS OV-N/"\LS QUANTITIES AND STORAGE (I indoors; OUT=outdoor: �f Case lots Drums AboveTanks Undetgro.und Tanks MAJOR MATERIALS IN UT IN—IOUT IN I G 92110nse Fuels: ' Gasoline, Jet Fuel (A) r -i Die , er , (B) Heavy Oils: waste motor oil (C) : new motor oil (C) transmission/hydraulic Synthetic Organics: . degreasers Mis cep�aneeoeJus: i J i DISPOSAL RECLAMzATION REW.RKS: 1 1. Sanitary Sewage 2. Water Supply 0 Town Sewer Public _ On-site Pr'va e .3. Indoor Floor Drains: YES NO O Holding tank: MDC °` OCatch basin/Dry well ... _._.._...._. .._----.•_-._._.... ._.____ 0 On-site system 4. Outdoor Surface drains:YES NO ' O Holding- tank: MDC ____ OCatch basin/Dry well _ ---- - -- -~ OOn-site system S. Waste Transporter Licensed? hPetinatinn _ Watee• ProdLct ei Person s) n . iewe Inspector Date TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM ADDRESS A/ Major types of material's: 1) //w4/,rt 2) ! '�„ �� � - 3} l' I. Description of material(s) use: II. Storage (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles,jars �- drums,barrels aboveground tanks / el / 7r�r /" underground tanks bags,boxes open,loose,uncovered inadequate labelling (1 B. Storage Facility ✓or # Remarks/Recommence:: -ions 1. Indoor �,- a) separate, contained room b) stored in general work area i) inadequate ventilation %1 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 67 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 / l/ a) name of hauler b) address or disposal site Perso.n(s) Interviewed �— _ — �— — — — — — — — — Inspector — _ I_�f r — — — — — — — — Date 6 30 81 TOWN OF BAR N STA B L E COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r •� a Q satisfactory 2• Printers BOARD OF HEALTH 3. Auto Body Shops O unsatisfactory- 4. Manufacturers c '6> !:--&-s (see"Orders") S. Retail Stores COMPANY Can lam- 0 6. Fuel Suppliers ADDRESS "` � _�_ __ `~' ''^� Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Underground Tanks 1IN UT IIN IOUT IN IOUT # izallons Aizerest? Fuels: Gasoline, Jet Fuel (A) F7 Diesel, Kerosene, #2 (B) Heavy Oils: � . f waste motor oil (C) t new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply OTown-Sewer 0 Publi -- 0 On-site ©.-P-rivate i 3. Indoor Floor Drains: YES NO O Holding tank: MDC O Catch basin/Dry well On-site system �- 4. Outdoor Surface drains:YES NC O Holding; tank: MDC J O Catch basin/Dry well 0-6n--site system S. Waste Transporter Licensed? Name of Hauler. Desti_nati on ..Waste 4j�U a / CIS 12 23 81 Person(s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: 'I,, �` -� �� Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 .rJrG � i Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totaling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO ��pp'' 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 Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners i/ Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants 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) Wood preservatives (creosote) Rustproofers Swimming pool chlorine i/ Car wash detergents Lye or caustic soda Jewelry cleaners Asphalt & roofing tar Leather dyes I/ 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) _0419!!� � Other cleaning solvents !✓ .� _ �/ Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business 1 -. �r .�-, i .F+'..,... . w.-- —.ram,:-:s•r+".e'-.:[,.a7 a�,..:�i, .;`,.^'4,,, y:+5..�.-.r..l'�e�T s�A•..�'. '-'wfi r'.....r..^�C'a-#xY�^r"..�:r Y..,".,+ :4-r�k�.... TOWN{@F'mBARNSTABLE COMPLIANCE: CLASS 1.Marine,Gas Stations,Repair BOARD OF HEALTH, o'"`satsfactory 2.Printers r 3.Auto Body Shops . ,� , , O unsatisfactory- 4.Manufacturers COMPANY v , �� r �4 (see"Orders") 5.Retail Stores j i. 6.Fuel Suppliers ADDRESS •,y. 7� .,�` "3�r%�'`C1835: �r`�„ 7•Miscellaneous . � QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: - Gasoline,Jet Fuel(A) . t Dies,el, Kerosene, #2 (B) rk Heavy Oils: waste motor oil.°(C) r } new motor oil(C) r r� transmission/hydraulic ..Y Synthetic Organics: _ degreasers '. A ; Miscellaneous: rr .* v DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply /Ear .•O Town Sewer OPublic � "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 1� tLi O Catch basin/Dry well it e<'7 O On-site system 5.Waste Transporter DestinationName of Hauler 2. 'Person (s) Interviewed Inspector' l -'Date' ! _ RETAIL BRAKES WHOLESALE CALIPERS 146 THORNTON DRIVE HYANNIS.MA 02601 JOBBER WAREHOUSE FOREIGN&AMERICAN CARL MARCHETTI WHILE U WAIT (508)778-4609. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM / ,- Mail To: NAME OF BUSINESS: G� �' R �"��� _ Board of Health MAILING ADDRESS: � Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: � ,� �. �2,e�� � Hyannis, MA 02601 7 40 y/V 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 i 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, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) X 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, vim, 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 MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �°�� �_ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS h� lass: 7.Miscellaneous E!�"�--"A--�A ANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drurns 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 �✓ Synthetic Organics: degreasers 6 l Miscellaneol6e DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply /� �� � � a r;w,— O Town Sewer Oublic 3'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 Y 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 2. erson (s) nterviewedInspector- Date 10 A :1hJE OF F,I.Rtl: Board of Health b1AILING ADDRESS: 15-7 Town of Barnstable TELEPHONE NLJ?IBER: ��'�' a P.O. Box 534 " Hyannis, Massachusetts 0260*;. k{y 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 NO V This form must be returned to the Board of Health regardless of a YES or NO '_• answer. 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 g i liquid volume or 2 n d weight. Plea eput �;totalling more than 50 gallons qu d v S pounds dry g s a 'check beside each product that you store: a - Antifreeze (for gasline or coolant systems ) Refrigerants Automatic transmission fluid Pesticides (insecticides , Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals = u Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) } R 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) ter Car wash detergents PCB' s Car waxes and polishes Other chlorinated -hydro- Asphalt & roofing tar carbons (inc.carbon Paints, varnishes , stains, dyes tetrachloride) �f Paint and lacquer thinners ' Any other products with x= Paint& Varnish removers, deglossers "Poi, „ rl pn labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other' Metal polishes acids) 77 Laundry soil & stain removers fit(including bleach) . Other products not listed 3 which you feel may be s ':Spot removers & .cleaning fluids toxic or hazardous (please. ?< �: (dry cleaners ) z = list) : , Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners f ,y Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite) 1. k �f .may R, "•� .. r •'x� i ter c-. '4�.. Y ,. t ','`„ �O W N O F BA R N STA B L E COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r 2. Printers ajOARD OF HEALTH isfactory 3. Auto Body Shops 5� I O unsatisfactory- 4. Manufacturers COMPANY 1 (lrl ��?,�� ;- � Y � (see 5. Retail Stores 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors MAJOR MATERIALSCase lots Drums AbdveTanks Undergrouad Tanks IN UT I IN IOUT IN IOUT # & g2llon Age frest. Fuels: Gasoline, Jet Fuel (A) i Diesel, Kerosene, #2 (B) i Heavy Oils: j waste motor oil (C) I 4 new motor oil (C) j I transmission/hydraulic E j Synthetic Organics: degreasers I Mi lianeous: j DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewa 2. Water Supply To Sewer 0 Public n-siteb-f-rivate _ 3. Indoor Floor Drains: YES N0. ® Holding tank: MDC Catch basin/Dry well _ On-site system ORDE f'- 4. Outdoor Surface drains:YES NC4— t Holding tank: %IDC ® Catch basin/Dry well ----.----_.___----._____.----- _- _ OOn-s'i t e system -- S. Waste Transporter Licensed? Name of Hauler J Rastc Product tES4 NO 2. ? I f /,�, .I l d � 'ECG ` s, ,� Z 23 Rt Person(s) Int.erview .d Inspector Date XAIN OF BARNS C ABILt':E G MPLIAN( yCLASS: 1. Karine,Gas Stations,Repair ® sa isfactory 2. Printers BOAR ® EALTH 3. Auto Body Shops ?4 �/1 ®unsatisfactory- 4. Manufacturers OMPANY r; (see Orders ) S. Retail Stores 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Undetgrauad Tanks IN OUT IN IOUT F IN IOUT vEllons Rve Tres ? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: a waste -motor oil (C) new motor oil (C) -, transmission/hydraulic -.� ' Synthetic Organics: degreasers - _ .. Miscellaneous: b'trj DISPOSAL RECLAMATION' REMARKS: 1. Sanitary wage 2. Water Supply own SewerOLP61ic o On-site 0 Priv*te 3. Indoor Floor Drains: YES NO' Holding tank: MDC Catch basin/Dry well ORDER I __ On-site system I � ! >>�c<_-� 0 �y � � --- 4. Outdoor Surface drains:YES NC _., Q Holding tank: MDC• ® Catch-basin/Dry well OOn-site system - — -- S. Waste` r sportR3 j' i Tr, l" i sed. Name of"Haul D .c i na i on i' ►is e �Prod�?c �� Person(s) Interviewed .12 23 81 Inspector Date s ;, _ _ COMPLIANCE: " ' CLASS: f Marine,Gas Stations,Repair �W�V OF �3ARNSTA C3L`� � �� ,� • atisfactory 2. Printers QOAR D' OE 'HEALTH 4;' btanufacturersps ,. unsatisfactory- IMPANY `1 , 6 { , se,.e"Orders" S, Retail Stores IURES5 P 6. Fuel Suppliers ' � Class: . j 7. 'MsTcellanevus L 11 QUANTITIES AND SIORAGE (INSindoors; OUT-outdoors) JOR MATERIALS Gase lots Drums ' AboveTanks Underground Tanks IN U1, ILLQ,� 1 6 fellons a hest? Fuels: -- — ! � . �• Gasoline, Jet Fuel (A) r r �Diesel,' Kexosene, 12 (0) I n Leavy Oils: i waste motor oil .. (C) • Y 1 new motor .oil (C) transmission/hydraulic synthetic ,Organics: 1 degreasers 1' iscellaneous: 1 a F U-1 A U FLEULAFXr1UI I REM US: . Sanitary Sewage. 2. Water Supply 0 Town'Sewer `public , - 1 Private a ,K, ,Indoor Floor Drains: YES NO O Holding tank: MUC ' I O Catch basin/Dry well 0 On-site system Outdoor Surface drains:•YES N( ' ilaldinL tank: Me Q Catch basin/Dry well , I. Q On-site system - Waste Transporters •. Licensed? Name-of Naul,erT I hentIna t Inn r Maete Prndu _t x ES TVT , r 1. .f•.,.:/�`'. s f TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: �� �� � � � Board of Health MAILING ADDRESS: Town 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 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 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 Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants r/ Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants 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) 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) Ll 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) t/ Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business .•.-;,,,_ ;i';r,-.�N+'a.-.-.r5r-.•-�..+�r._"s¢'*i%.-t�-��t-:^;?.,:a•.�f.>,,r+�y,yn.r;�t-,+�air��.;w"""`;;�. ..�.-vc:.;c,srr,,-.�y':�:-.r,,,!'�.F4�I.+:i ,�nr-..EE';,.� ,�^',r'^d'7'" '�, «•2.�. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH/ 3.Auto Body Shops _ O unsatisfactory- 4.Manufacturers COMPANY(JA 4 Mc I'1 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS .42� �,p 41 '/217A(Class: 7.Miscellaneous �T,�~,IQUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALSUnderground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) piesel, Kerosene, #2(B) �� { Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers ��',s�t.� _.�".�#,.��+�r� `!✓ilk � ! ,f/ Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Public Q On-site ; OPrivate 3. Indoor Floor Drains YES NO a O Holding tank: MDC O Catch basin/Dry well O Qn-site system 4. Outdoor Surface drains:YES NO ORDERS: 0-Holding tank:MDC .O Catclrbasin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. ///7 X A Person(s) Interviewed Inspector /Date ` :, _ - TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: _ - Board of Health MAILING ADDRESS: , Town of Barnstable TELEPHONE NUMBER: /— 3 // P.O. Box 534 CONTACT PERSON: W OL Hyannis, MA 02601 Does your fir/iies any of the toxic or hazardous materials listed below, either for sale or for your own use, in qu totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES 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 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, #2 heating oil Pesticides (insecticides, herbicides, m r grease, lubricants rodenticides Other petroleum products:p P 9 � ) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) RustP roofers 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 -« /+s�:-� .-.,r.�_.. _,.we3,.y,r- ...«4,+'�d::y......•F'+rj-3.-+,,ri. �,.•.a.:4,w.:r .r.u.i, ;;„".t_�a+^�. „l'�,n.`..fR�,,�ti--.*,.An!3-...�-'a' -'* -�.:..nF'...-._a...:`-'Kr��.Y.'�^«:.�, ��. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Sta-tions,Repair �" i 2.Printers -BOARD OF HEALTH ;® satisfactory 3.Auto Body Shop�I 0 unsatisfactory- 4.Manufacturers COMPANY . +_ ,rig (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 7 ��? ���.a `�a� Class: 0'> 7.Miscellaneous ,QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lot, Drums Above Tanks Underground IN OUT ' IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: y waste motor oil (C) Y ell new�mo�to�r-oil (.C�) transmission/hydraulic Synthetic Organics: `� , degreasers Miscellaneous: 17 U V DISPOSAIJRECLAMATION REMARKS: .. 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic 0 On-site OPrivate f ry 3. Indoor Floor Drains YES—No • O Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 2. + Person(s) Interviewed . Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM �� ��� � C, Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: f7airagwn of Barnstable TELEPHONE NUMBER: �7 ;7 �' �' _ 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 totalli g, 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 i 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/wash a oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: reuse, lubricants rodenticides) L 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 2.Printers satisfactory BOARD OF HEALTH 3.Auto Body Shops p unsatisfactory- 4.Manufacturers COMPANY / (see"Orders") 5.Retail Stores ,, 6.Fuel Suppliers ADDRESS �� «glass• 7.Miscellaneous TITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drurris Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: . waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degr ase�rs� Miscellaneous: DISPOSAL/REC;LAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply j O Town Sewer Public ('On-site OPrivate 3. Indoor Floor Drains YES NO V' 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 Destination Waste Product LicensedT 1• �",/ � � G � l/1! LJ � YES NO 2. Person (s Interviewed Inspector Date