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EL <br /> Y ;y Groundwater Permit <br /> MONITORING WELL DATA REPORT 2,Tax identification Number <br /> 12019 NOV MONTHLY <br /> 3. Sampling Month&Frequency <br /> A. Facility Information <br /> Important:When <br /> filling out forms on 1. Facility name,address; <br /> the computer, use SOUTH CAPE VILLAGE <br /> only the tab key to a.Name <br /> move your cursor- - -- - - - <br /> do not use the 672 FALMOUTH ROAD/RTE.28 <br /> return key. b.Street Address <br /> MASHPEE IMA 102649 <br /> C.City d.State e.Zip Code <br /> 2. Contact information: <br /> MYLES OSTROFF <br /> a.Name of Facility Contact Person <br /> 6174311097 myles@chartweb.com <br /> b.Telephone Number c.e-mail address <br /> 3. Sampling information: <br /> 11/6/2019 WHITEWATER <br /> a.Date Sampled(mm/dd/yyyy) b.Laboratory Name <br /> LAURAJOHNSON <br /> c.Analysis Performed By(Name) <br /> B. Form Selection <br /> 1. Please select Form Type and Sampling Month&Frequency <br /> Monitoring Well Data Report-2019 Nov Monthly Y <br /> r All forms for submittal have been completed. <br /> 2. This is the last selection. <br /> 3. Delete the selected form. <br /> i <br /> i <br /> gdpols 2015-09-15.doc•rev.09/15/15 Groundwater Permit Daily Log Sheet-Page 1 of 1 <br />