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Get Var 10 General Permit Form

T coverage will be issued to this operator. The Certification in Item #12 must be signed by the appropriate person associated with this operator.) Name: Contact: Mailing Address: City: State: Zip: Phone: Email address (if available): Indicate if DEQ may transmit general permit correspondence electronically: Yes 2. 3. No Existing General Permit Registration Number (for renewals only): Name and Location of the Construction Activity: Name: Address (if available): City: State: Zip: County (.

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