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LIC Form 3756 PDF 61: How to Claim a Duplicate Policy with the Covenant for Lost or Misplaced Policy



For more detailed information about Emissions Statement Reporting Form, please visit the Reporting Requirements for Ground-level Ozone Nonattainment Areas website or contact Chad Wilbanks at (803) 898-4106.


The following forms were created to assist facilities with reporting required by construction or operating permits. Use of these forms is not mandatory. These forms are intended for guidance purposes only and may not be applicable to all facilities. Some forms require manipulation so that spreadsheets represent materials used at your facility.




lic form 3756 pdf 61



Construction Permit Application - Drinking Water and/or Wastewater Facilities - This form must be completed as part of an application package submitted for DHEC approval of water and/or wastewater systems construction plans.


NPDES Application Form 1 - General Information - This is EPA's Application Form 1. It contains general information about the applicant and facility. This form must accompany the NPDES permit application


NPDES Application Form 2C - Wastewater Discharge Information - EPA Form 2C is used by existing industrial facilities when reapplying for an NPDES permit. Instructions are included. This form must be accompanied by EPA Form 1, the Location Supplement, and the Sludge Supplement.Location Supplement for NPDES and ND Permit ApplicationsSludge Disposal Supplement for NPDES and ND Permit ApplicationsMixing Zone Supplement


NPDES Application Form 2D - New Dischargers and New Sources: Application to Discharge Process Wastewater - EPA Form 2D is used by industrial facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by EPA Form 1, the Antidegradation Supplement, the Location Supplement, and the Sludge Supplement.Location Supplement for NPDES and ND Permit ApplicationsSludge Disposal Supplement for NPDES and ND Permit ApplicationsMixing Zone Supplement


NPDES Application Form 2E - Facilities Which Do Not Discharge Process Wastewater - EPA Form 2E is used by facilities which do not discharge process wastewater. Instructions are included.This form must be accompanied by EPA Form 1, the Location Supplement, and the Sludge Supplement.Location Supplement for NPDES and ND Permit ApplicationsSludge Disposal Supplement for NPDES and ND Permit ApplicationsMixing Zone Supplement


NPDES Application Form 2A - New and Existing Publicly Owned Treatment Works - EPA Form 2A is used by municipal facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by the Antidegradation Supplement, the Location Supplement, and EPA Form 2S.Location Supplement for NPDES and ND Permit ApplicationsSludge Disposal Supplement for NPDES and ND Permit ApplicationsMixing Zone SupplementPart D-Excel spreadsheet application data


NPDES Application Form 2S - New and Existing Treatment Works Treating Domestic Sewage - EPA Form 2S is used by municipal facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by the Form 2A and the Location Supplement.Location Supplement for NPDES and ND Permit Applications


The clerk issuing any marriage license shall require the parties contemplating marriage to state, under oath, the information required to complete the application for marriage license. The parties shall be able to designate themselves on the application for marriage license as spouse, bride, or groom. The clerk shall provide the parties with two copies of the marriage certificate to be completed by the marriage officiant, who shall return the completed certificates to the clerk after the marriage ceremony of the parties. The clerk shall retain one copy of the completed marriage certificate and provide the other copy to the State Registrar of Vital Records. The clerk may provide the parties with a commemorative marriage certificate and the parties may request a certified copy of the official marriage certificate as provided in Article 7 ( 32.1-270 et seq.) of Chapter 7 of Title 32.1. For the purposes of this section any statement made by such applicant, under oath, concerning the information to be entered on the application for marriage license is hereby declared to be a material matter or thing in any prosecution for perjury for any violation of this section.


Marriages between persons belonging to any religious society which has no ordained minister, may be solemnized by the persons and in the manner prescribed by and practiced in any such society. One person chosen by the society shall be responsible for completing the certification of marriage in the same manner as a minister or other person authorized to perform marriages; such person chosen by the society for this purpose shall be required to execute a bond in the penalty of $500, with surety. No oath shall be required of a person authorized to celebrate the rites of marriage, nor shall such person be considered an officer of the Commonwealth by virtue of such authorization.


If any person knowingly perform the ceremony of marriage without lawful license, or officiate in celebrating the rites of marriage without being authorized by law to do so, he shall be confined in jail not exceeding one year, and fined not exceeding $500.


The clerks of the circuit courts of any counties or their deputies and the clerks of the circuit courts of any cities or their deputies are authorized to issue marriage licenses in conformity with the law now governing the same, to any persons desiring to be married on any of the government reservations of this Commonwealth, lying within their respective counties and which reservations were before the acquisition thereof part of the political territory of this Commonwealth, and any marriage ceremony performed on such reservations shall be as legal to all intents and purposes as if performed in any county or city of the Commonwealth, if the person performing the ceremony was qualified to so act.


All marriages heretofore solemnized outside this Commonwealth by a minister authorized to celebrate the rites of marriage in this Commonwealth, under a license issued in this Commonwealth, and showing on the application therefor the place out of this Commonwealth where said marriage is to be performed, shall be valid as if such marriage had been performed in this Commonwealth.


C. The results of a scientifically reliable genetic test, including a blood test, may be admitted in evidence when contained in a written report prepared and sworn to by a duly qualified expert, provided the written results are filed with the clerk of the court hearing the case at least fifteen days prior to the hearing or trial. Verified documentary evidence of the chain of custody of the blood specimens is competent evidence to establish the chain of custody. Any qualified expert performing such test outside the Commonwealth shall consent to service of process through the Secretary of the Commonwealth by filing with the clerk of the court the written results. Upon motion of any party in interest, the court may require the person making the analysis to appear as a witness and be subject to cross-examination, provided that the motion is made at least seven days prior to the hearing or trial. The court may require the person making the motion to pay into court the anticipated costs and fees of the witness or adequate security for such costs and fees.


2. Medical or anthropological evidence relating to the alleged parentage of the child based on tests performed by experts. If a person has been identified by the mother as the putative father of the child, the court may, and upon request of a party shall, require the child, the known parent, and the alleged parent to submit to appropriate tests;


Whenever in any legal proceedings a man voluntarily testifies under oath or affirmation that he is the father of a child whose parents are not married, or are not married to each other, the court may require that he complete an acknowledgment of paternity on a form provided by the Department of Social Services. This acknowledgment shall be sent by the clerk of the court within thirty days of completion to the Department of Social Services.


In any proceeding under this chapter, the petitioner may request a true copy of this form from the Department of Social Services and the Department shall remit such form to the court where the petition has been filed. Such true copy of an acknowledgment of paternity shall then be admissible in any proceeding under this chapter.


C. For each court determination of parentage made under the provisions of this chapter, a certified copy of the order or judgment shall be transmitted to the State Registrar of Vital Records by the clerk of the court within thirty days after the order becomes final. Such order shall set forth the full name and date and place of birth of the person whose parentage has been determined, the full names of both parents, including the maiden name, if any, of the mother and the name and address of an informant who can furnish the information necessary to complete a new birth record. In addition, when the State Registrar receives a document signed by a man indicating his consent to submit to scientifically reliable genetic tests, including blood tests, to determine paternity and the genetic test results affirming at least a ninety-eight percent probability of paternity, a new birth record shall be completed as provided in 32.1-261. When the State Registrar receives a copy of a judgment or order for a person born outside of this Commonwealth, such order shall be forwarded to the appropriate registration authority in the state of birth or the appropriate federal agency.


An individual may file a petition for relief and, except as provided herein, the court may set aside a final judgment, court order, administrative order, obligation to pay child support or any legal determination of paternity if a scientifically reliable genetic test performed in accordance with this chapter establishes the exclusion of the individual named as a father in the legal determination. The court shall appoint a guardian ad litem to represent the interest of the child. The petitioner shall pay the costs of such test. A court that sets aside a determination of paternity in accordance with this section shall order completion of a new birth record and may order any other appropriate relief, including setting aside an obligation to pay child support. No support order may be retroactively modified, but may be modified with respect to any period during which there is a pending petition for relief from a determination of paternity, but only from the date that notice of the petition was served on the nonfiling party. 2ff7e9595c


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