Section Env-Wq 304.11 - Information Required For Application The applicant shall provide the following on or with the application form:
(a) Applicant's name, home mailing address, home and business telephone numbers, and, if available, an email address;(b) Applicant's date of birth;(c) For each current wastewater operator certification held by the applicant, the following: (1) The state that issued the certification;(2) The grade of the certificate;(3) The number of the certificate;(4) The date the certificate was issued; and(5) Whether the certificate was achieved by examination;(d) Whether the application is for reciprocity;(e) The grade level applied for;(f) Whether the applicant is requesting any education or experience substitutions;(g) Applicant's educational background, as follows:(1) The highest year of high school completed and the name and location, by town and state, of the high school;(2) The year of high school graduation or date of HSE certificate, as applicable;(3) The number of years of post-high school education completed, including whether an associate's or bachelor's degree was earned, major, minor if any, the name and location of the educational institution by town and state, and the year of graduation, if any;(4) If requesting additional education to be applied toward experience requirement, the title, name and location of educational institution, date completed, and number of credits awarded for each such course;(5) Proof of high school graduation or HSE certificate, if no post-high school education has been attained; and(6) Proof of post-high school education in the form of transcripts or certificates of course completion;(h) Applicant's experience history for wastewater-related employment with the most recent experience listed first, including for each position held the name and address of the employer, the type of facility including treatment and solids handling units, the position title, the name and title of the supervisor for that position, a complete description of duties, whether the employment was full or part time, and, if part time, the average number of hours worked per week;(i) Verification of experience by signature of either the operator in responsible charge or permittee; and(j) The names, addresses and daytime telephone numbers of 2 references who are not related to the applicant and who have knowledge of the applicant's character, experience, and abilities.N.H. Admin. Code § Env-Wq 304.11
(See Revision Note at part heading for Env-Wq 304) #10392, eff 8-1-13