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Massachusetts Department of Environmental Protection 668 <br /> Bureau of Resource Protection-Groundwater Discharge Program 1. Permit Number <br /> Groundwater Permit2.I <br /> t DISCHARGE MONITORING REPORT Mcation Number <br /> Tax i ent <br /> ONTHLY <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 MA 02649 <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 /> 6/1/2022 RI ANALYTICAL <br /> a.Date Sampled(mm/dd/yyyy) b.Laboratory Name <br /> JONATHAN AUGUSTE <br /> c.Analysis Performed By(Name) <br /> B. Form Selection <br /> 1.Please select Form Type and Sampling Month&Frequency <br /> Discharge Monitoring Report-2022 Jun Monthly <br /> All forms for submittal have been completed. <br /> 2. �- This is the last selection. <br /> 3. �-Delete the selected form. <br /> gdpols 2015-09-15.doc•rev. 09/15/15 Groundwater Permit Daily Log Sheet• Page 1 of 1 <br />