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PRINTED: 09/25/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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The form surveyor entered form is a document used for reporting specific data related to surveying and land measurements.
Individuals or companies engaged in surveying activities and responsible for reporting data as mandated by regulatory authorities are required to file the form.
To fill out the form, provide accurate and complete information as specified in the instructions, including survey details, measurements, and any other required data.
The purpose of the form is to ensure accurate reporting of surveying activities, which aids in maintaining regulatory compliance and supporting land management.
Information such as surveyor's details, survey site location, measurement data, and any relevant notes must be reported on the form.
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