Navigating the obligations and requirements of environmental compliance can be an intricate process for both residents and businesses. One critical aspect of ensuring adherence to environmental regulations is the DEQ 641 581Cert form, a document provided by the Environmental Complaints and Local Services Division. This certification documentation form plays a pivotal role in the process of modifying or installing on-site sewage treatment systems in Oklahoma. Its primary function is to confirm the details of the sewage treatment system being installed or modified, including specifying the number of bedrooms in a residence or the anticipated water usage of a business, which is essential for appropriately sizing the system. This form serves as an official record that captures general information about the property owner, the property address, and the legal description of the site. Moreover, it requires a certification related to the flow of the sewage system, underscoring the adherence to specific sections of Oklahoma statutes. By signing this document, the property owner or responsible party pledges under penalty of law that all provided information is true, accurate, complete, and free of any willful or negligent misrepresentation. Issued with a revision date of April 30, 2010, the DEQ Form 641-581cert symbolizes a critical step towards environmental compliance, reflecting a broader commitment to maintaining public health and protecting natural resources.
| Question | Answer |
|---|---|
| Form Name | Deq Form 641 581Cert |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | 641 581sp form, oklahoma deq 641, deq form 641, form 641581 |
ENVIRONMENTAL COMPLAINTS AND LOCAL SERVICES DIVISION
CERTIFICATION DOCUMENTATION FORM
Work Order No.
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System No. |
(PLEASE PRINT OR TYPE) |
Date Rec’d |
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GENERAL INFORMATION:
Name and Mailing Address of Property Owner:
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First Name |
Last Name |
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Street Address |
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City |
Zip Code |
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Owner’s |
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Property Address: |
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, Oklahoma |
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Street Address |
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City |
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Zip Code |
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County |
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Legal Description: |
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Lot Size in: |
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ft2, or |
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acres |
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Finding Location:
(Blocks or miles from a given point)
Please check the applicable certification that applies and sign below.
FLOW CERTIFICATION:
27A O.S. Section
This individual sewage treatment system will serve an individual residence or duplex with the following # of
bedrooms: .
The estimated flow or actual flow for this small public sewage system is |
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gal/day and is a |
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Type of Facility |
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I hereby certify under penalty of law that this document contains no willful or negligent misrepresentation or falsification and that all information is true, accurate and complete.
Print First Name |
Last Name |
Signature |
Date Signed |
Revised 4/30/2010 |
DEQ Form |