Bwcs126, Miscellaneous Document Transmittal Form Page 4
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4Massachusetts Department of Environmental Protection
BWSC126
Bureau of Waste Site Cleanup
Release Tracking Number
Miscellaneous Document Transmittal Form
Check here if any non-updatable information provided on this form is incorrect, e. g. property address. Send corrections to
BWSC.eDEP@state.ma.us
YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN
THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM, YOU MAY BE
PENALIZED FOR MISSING A REQUIRED DEADLINE.
Date Stamp (DEP USE ONLY):
Revised: 09/17/2013
Page 4 of 4
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