Signature of Person Preparing the Request (if Date different than above) Name (print or type) Note: Additional pages may be used to complete answers Prepared for the Water Resources Commission by the Department of Conservation and Recreation, Office of Water Resources: August 2018. APPENDIX A Maximum Potential Insignificant Surface Water Transfers for Transfers Derived Primarily from Lakes, Ponds, Reservoirs or Other Impoundments To be Updated when the Massachusetts Drought Management Plan is Revised 1. Select the appropriate town(s) from the following list: MASSACHUSETTS TOWNS BY REGION Athol Spencer CAPE COD REGION Auburn Sterling Barnstable Barre Sturbridge Bourne Boylston Sutton Brewster Brookfield Templeton Chatham Charlton Townsend Chilmark Douglas Uxbridge Dennis Dudley Warren Eastham East Brookfield Webster Edgartown Fitchburg West Boylston Falmouth Gardner West Brookfield Gay Head Grafton Westminster Gosnold Hardwick Winchendon Harwich Holden Worcester Mashpee Hubbardston Nantucket Leicester CONNECTICUT Oak Bluffs Leominster RIVER REGION Orleans Lunenburg Agawam Provincetown Millbury Amherst Sandwich New Braintree Ashfield Tisbury North Brookfield Belchertown Truro Northbridge Bernardston Wellfleet Oakham Blandford West Tisbury Oxford Brimfield Yarmouth Paxton Buckland Petersham Charlemont Phillipston Chester ISLANDS Princeton Chesterfield CENTRAL Royalston Chicopee REGION Rutland Colrain Ashburnham Shrewsbury Conway Ashby Southbridge Cummington
Date Signature of Person Preparing the Request (if different than above) Name (print or type) Note: Additional pages may be used to complete answers Prepared for the Water Resources Commission by the Department of Conservation and Recreation, Office of Water Resources: August 2018. APPENDIX A Maximum Potential Insignificant Surface Water Transfers for Transfers Derived Primarily from Lakes, Ponds, Reservoirs or Other Impoundments To be Updated when the Massachusetts Drought Management Plan is Revised 1. Select the appropriate town(s) from the following list: MASSACHUSETTS TOWNS BY REGION CAPE COD REGION Barnstable Bourne Brewster Chatham Chilmark Dennis Eastham Edgartown Falmouth Gay Head Gosnold Harwich Mashpee Nantucket Oak Bluffs Orleans Provincetown Sandwich Tisbury Truro Wellfleet West Tisbury Yarmouth ISLANDS CENTRAL REGION Ashburnham Ashby Athol Auburn Barre Boylston Brookfield Charlton Douglas Dudley East Brookfield Fitchburg Gardner Grafton Hardwick Holden Hubbardston Leicester Leominster Lunenburg Millbury New Braintree North Brookfield Northbridge Oakham Oxford Paxton Petersham Phillipston Princeton Royalston Rutland Shrewsbury Southbridge Spencer Sterling Sturbridge Sutton Templeton Townsend Uxbridge Warren Webster West Boylston West Brookfield Westminster Winchendon Worcester CONNECTICUT RIVER REGION Agawam Amherst Ashfield Belchertown Bernardston Blandford Brimfield Buckland Charlemont Chester Chesterfield Chicopee Colrain Conway Cummington
RDI_Application.docx