"Application for Renewal of Solid Waste Facility Operator Certification" - New Mexico

Application for Renewal of Solid Waste Facility Operator Certification is a legal document that was released by the New Mexico Environment Department - a government authority operating within New Mexico.

Form Details:

  • Released on April 1, 2017;
  • The latest edition currently provided by the New Mexico Environment Department;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Environment Department.

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Download "Application for Renewal of Solid Waste Facility Operator Certification" - New Mexico

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NEW MEXICO ENVIRONMENT DEPARTMENT
Application for Renewal of Solid Waste Facility Operator Certification
PRINT LEGIBLY
Mr.
Mrs.
Ms.
Last Name
First Name
Middle Initial
Operator ID #
Certification Renewal :
Expiration Date:
Course Name:
(Check one box)
Compost Facility Operator
Compost Facility Operator Certification Course
Recycling Facility Operator Certification Course
Recycling Facility Operator
Landfill Operator Certification Course
Landfill Operator
Processing Facility Operator
Transfer Station/ Processing Facility Operator Certification
Transfer Station Operator
Transformation Facility Operator Certification Course
Transformation Facility Operator
Course Date:
Course Location:
HOME (MAILING) ADDRESS
FACILITY
Address
Name of the facility where you work:
City
State
Zip
Address
Home phone No.
Cell phone No.
City
Zip
* E-mail address
Facility phone No.
FAX No.
*You must provide a valid e-mail address to access your certification
information online. Please print clearly!
Your current job title:
I hereby certify there are no misrepresentations in the information I am providing. I am aware that if an investigation discloses any
discrepancies, my application may be rejected and any certification received as a result of this application may be revoked.
SIGNATURE:
DATE:
THIS SECTION FOR DEPARTMENT USE ONLY
Application received
Initials:
Date
Parental Responsibility Act Verification
Initials:
Date
Education & Training Verification
Initials:
Date
Complete database Entries
Initials:
Date
Certificate Issued
Expires:
Initials:
Date
Notification Letter & Certificate Mailed
Initials:
Date
New Mexico Environment Department, Solid Waste Bureau 1190 St. Francis Dr.
Return completed and signed application to:
Room N2150, P.O. Box 5469, Santa Fe, NM 87502-5469 Attn: William Schueler
Revised April 2017
NEW MEXICO ENVIRONMENT DEPARTMENT
Application for Renewal of Solid Waste Facility Operator Certification
PRINT LEGIBLY
Mr.
Mrs.
Ms.
Last Name
First Name
Middle Initial
Operator ID #
Certification Renewal :
Expiration Date:
Course Name:
(Check one box)
Compost Facility Operator
Compost Facility Operator Certification Course
Recycling Facility Operator Certification Course
Recycling Facility Operator
Landfill Operator Certification Course
Landfill Operator
Processing Facility Operator
Transfer Station/ Processing Facility Operator Certification
Transfer Station Operator
Transformation Facility Operator Certification Course
Transformation Facility Operator
Course Date:
Course Location:
HOME (MAILING) ADDRESS
FACILITY
Address
Name of the facility where you work:
City
State
Zip
Address
Home phone No.
Cell phone No.
City
Zip
* E-mail address
Facility phone No.
FAX No.
*You must provide a valid e-mail address to access your certification
information online. Please print clearly!
Your current job title:
I hereby certify there are no misrepresentations in the information I am providing. I am aware that if an investigation discloses any
discrepancies, my application may be rejected and any certification received as a result of this application may be revoked.
SIGNATURE:
DATE:
THIS SECTION FOR DEPARTMENT USE ONLY
Application received
Initials:
Date
Parental Responsibility Act Verification
Initials:
Date
Education & Training Verification
Initials:
Date
Complete database Entries
Initials:
Date
Certificate Issued
Expires:
Initials:
Date
Notification Letter & Certificate Mailed
Initials:
Date
New Mexico Environment Department, Solid Waste Bureau 1190 St. Francis Dr.
Return completed and signed application to:
Room N2150, P.O. Box 5469, Santa Fe, NM 87502-5469 Attn: William Schueler
Revised April 2017