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Must be completed by any facilities tha decommissions its system in accordance with the MassDEP Enforcement Discretion Directive.
Submit this form to MassDEP within 30 days of any change in Stage II System owner, lessee, operator or controller, Responsible Official, or recipient of annual compliance fee bills.
Use this form to notify MassDEP that you have either permanently closed a Stage II facility or temporarily taken it out of service.
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