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Get OK DEQ 641-581SP 2012

On Number Zip Phone # Date Signed DEQ USE ONLY: Soil Test Performed by DEQ on (date): DEQ Soil Profile Test Verification of Design Environmental Specialist’s Signature Revised 7/1/2012 OR Joint Soil Profile DEQ Reviewed Certified Soil Profiler’s Test Results Date Accepted: Notes: Employee ID Date Rejected: Date Signed Date Paperwork Issued DEQ Form 641-581SP Work Order No. System No. Owner’s Last Name SYSTEM DESIGN: Check all that apply TREATMENT: Septic Tank with gal. l.

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