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BOARD OF HEALTH 34 Broadway Rockport, MA 01966 (978) 5463701 Semipublic SPECIAL PURPOSE POOL PLAN REVIEW (105 CMR 435,000) (Initial Application) Name of Facility Address New () Remodeled () Owner

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Information that must be reported on rules and regulations governing includes details about the organization's governance structure, decision-making processes, conflict of interest policies, and compliance measures.