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Arkansas Department of Environmental QualitySolid Waste Management Division5301 NorthshoreNorth Little Rock, AR 72118(501) 6820601NOTICE OF INTENTION COVERAGE UNDER THE GENERAL PERMIT FOR THE CONSTRUCTION
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The form for coverage is a document used to report information related to health insurance coverage, typically required under specific regulations.
Employers and other entities providing health coverage are usually required to file the form for coverage details.
To fill out the form, gather the necessary information about the coverage, including insured individuals, coverage types, and duration, and complete the form as per guidelines provided by the regulating authority.
The purpose of the form is to ensure compliance with health coverage reporting requirements and to provide accurate information to regulatory bodies.
Information such as the names of insured individuals, their coverage types, and any applicable months of coverage must be reported on the form.
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