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DEPARTMENT OF ENVIRONMENTAL PROTECTION …

DEPARTMENT OF ENVIRONMENTAL PROTECTION bureau OF water & SEWER OPERATIONS SELF-CERTIFICATION APPLICATION - CROSS CONNECTION CONTROL PROGRAM DOUBLE CHECK VALVE (DCV) INSTALLATION PLAN - -- Domestic Service Only --- Page 1 Rev. 07/29/10 A. PROJECT DATA: Please fill out the form completely. Block #: Lot #: Borough: Name of Facility: Type of Facility: Address of Facility: City: State: NY Zip Code: Number of Domestic Service(s): Size: water System Pressure (psi) at Curb Elevation: Device Information: Manufacturer: Model Number: Size: B.

department of environmental protection bureau of water & sewer operations self-certification application - cross connection control …

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  Department, Protection, Water, Bureau, Environmental, Department of environmental protection, Department of environmental protection bureau of water

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