"Application for Post-exam Supplemental Experience and Education for Wastewater System Operator Certification" - Oregon

Application for Post-exam Supplemental Experience and Education for Wastewater System Operator Certification is a legal document that was released by the Oregon Department of Environmental Quality - a government authority operating within Oregon.

Form Details:

  • Released on September 1, 2021;
  • The latest edition currently provided by the Oregon Department of Environmental Quality;
  • 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 fillable version of the form by clicking the link below or browse more documents and templates provided by the Oregon Department of Environmental Quality.

ADVERTISEMENT
ADVERTISEMENT

Download "Application for Post-exam Supplemental Experience and Education for Wastewater System Operator Certification" - Oregon

Download PDF

Fill PDF online

Rate (4.5 / 5) 26 votes
State of Oregon Department of Environmental Quality
Instructions for the Application for
Post-exam Supplemental Experience
and Education –
Wastewater Operator Certification
For applicants after testing with a waiver for experience or
Operator In Training
(Note: do not send these instructions with your application – keep for your records)
Incomplete applications or incorrect fees will be returned for completion
Fill in all sections. If the information requested is not applicable, write N/A.
A. Applicant Information
Enter applicant’s legal name and last four digits of social security number.
B. Mailing Address and Contact Information & Current Employer
Complete all sections.
C. Application Certificate Type / Grade
Select one or two boxes, and the corresponding grade button for the exam type you passed, and you
now meet the qualifications for.
D. Fee
Make check for $50 payable to “Oregon DEQ” (for one or two certificates).
E. – F. College / University, Community College, or Trade School / Continuing Education Units
List your additional education awarded or earned after your previous application to DEQ. Attach a legible
copy of each listed item. Awarded degrees and other accumulation of academic credits documented on
transcripts and/or may be accepted in the fields of engineering, chemistry, water/wastewater technology,
physical, biological, or applied sciences, mathematics, or operation management per OAR 340-049-
0030(4). One or more years of post-high school education equals the following: 1 year = minimum of 45
quarter hours or 30 semester hours. List the semester/quarter credits and totals. Course credits outside
these fields/majors may be reviewed on a course-by-course basis through attaching transcript(s) to the
application.
G. Supplemental Wastewater Operator Work Experience History
All sections are required; include detailed and accurate information. Use the checkboxes to
summarize your duties and experience to show you now meet the requirements. The percentage blocks
per each listed job must total 100%. Attach additional page 2 if necessary. Provide a description
statement of your wastewater operator direct and related experience. “Direct” operator experience =
percent of the work history segment related to the certificate type. “Related” operator experience can
include wastewater collections (for Treatment certificate), wastewater treatment (for Collection
certificate), drinking water distribution, treatment, or lab work (for either). Describe any Industrial, Pre-
treatment, septic system maintenance, water testing laboratory, or storm water management experience
for consideration by DEQ. Domestic wastewater treatment system experience is direct experience for a
treatment certificate; domestic wastewater collections/conveyance system experience is direct
experience for a collections certificate. See the Qualifications Table, Instructions page iii. Direct and
Oregon DEQ Instructions for Application, Post-Exam Experience & Education, Operator Certification, September 2021
Page i of iii
State of Oregon Department of Environmental Quality
Instructions for the Application for
Post-exam Supplemental Experience
and Education –
Wastewater Operator Certification
For applicants after testing with a waiver for experience or
Operator In Training
(Note: do not send these instructions with your application – keep for your records)
Incomplete applications or incorrect fees will be returned for completion
Fill in all sections. If the information requested is not applicable, write N/A.
A. Applicant Information
Enter applicant’s legal name and last four digits of social security number.
B. Mailing Address and Contact Information & Current Employer
Complete all sections.
C. Application Certificate Type / Grade
Select one or two boxes, and the corresponding grade button for the exam type you passed, and you
now meet the qualifications for.
D. Fee
Make check for $50 payable to “Oregon DEQ” (for one or two certificates).
E. – F. College / University, Community College, or Trade School / Continuing Education Units
List your additional education awarded or earned after your previous application to DEQ. Attach a legible
copy of each listed item. Awarded degrees and other accumulation of academic credits documented on
transcripts and/or may be accepted in the fields of engineering, chemistry, water/wastewater technology,
physical, biological, or applied sciences, mathematics, or operation management per OAR 340-049-
0030(4). One or more years of post-high school education equals the following: 1 year = minimum of 45
quarter hours or 30 semester hours. List the semester/quarter credits and totals. Course credits outside
these fields/majors may be reviewed on a course-by-course basis through attaching transcript(s) to the
application.
G. Supplemental Wastewater Operator Work Experience History
All sections are required; include detailed and accurate information. Use the checkboxes to
summarize your duties and experience to show you now meet the requirements. The percentage blocks
per each listed job must total 100%. Attach additional page 2 if necessary. Provide a description
statement of your wastewater operator direct and related experience. “Direct” operator experience =
percent of the work history segment related to the certificate type. “Related” operator experience can
include wastewater collections (for Treatment certificate), wastewater treatment (for Collection
certificate), drinking water distribution, treatment, or lab work (for either). Describe any Industrial, Pre-
treatment, septic system maintenance, water testing laboratory, or storm water management experience
for consideration by DEQ. Domestic wastewater treatment system experience is direct experience for a
treatment certificate; domestic wastewater collections/conveyance system experience is direct
experience for a collections certificate. See the Qualifications Table, Instructions page iii. Direct and
Oregon DEQ Instructions for Application, Post-Exam Experience & Education, Operator Certification, September 2021
Page i of iii
Related experience is summed for the total experience required. System Type, Classification (SWWS –
IV), Permit # etc. are REQUIRED (see the facility Permit or the
Find Designated System Supervisory
PDF on the bottom of our webpage, for Oregon wastewater system
Wastewater Operators by Facility
details, file #, etc.) The Designated System Supervisor is the System Supervisor on record with DEQ. If
not in Oregon, include the principal supervising operator.
I.
Affidavit of Most Recent Operator Work Experience
The supervisor or manager is to complete this block about the applicant’s employment and the System.
Complete each block accurately; permit and file numbers are required.
J. Supervisor’s Statement (REQUIRED) of Applicant’s Routine Tasks and Duties and
Certification of Affidavit
The applicant’s supervisor, manager, public works director, city administrator, commissioner, mayor, or
the equivalent submits their own statement describing the applicant’s daily operator tasks and duties.
This person who certifies the Affidavit by initialing / signing / dating in Section J shall have sufficient
knowledge to submit the statement of the applicant’s routine duties and tasks in Section J. The official
position or job description from the employment or records office may be attached in addition—but not as
a substitution—for this statement from the supervisor in Section J.
K. Applicant Signature / Date (required from all applicants)
(ELECTRONIC SIGNATURES OR INITIALS ARE NOT ALLOWED)
Application Checklist
A complete application includes:
• All sections and blocks legible and complete
• Check payable to Oregon DEQ for $50
• Supplemental education documents if needed for this certification level and Path
• Detailed work experience (include duties, System information, state permit # and
file #, supervisor name / contact, etc.), page 2
• Complete Affidavit, page 3: Statement, initials, and hand signature / date from
manager
• Hand Signature / date from applicant on page 3, at bottom
• Proof-read your application for errors or omissions prior to mailing
• KEEP a COPY of this application for your records. Copy requests from DEQ will
incur a copying fee
Incomplete forms will be returned for completion.
Application fees are non-refundable.
Questions? Contact the Certification Program at
opcert@deq.state.or.us
or call
503-229-5349, 503-229-5161, or 800-452-4011.
Oregon DEQ Instructions for Application, Post-Exam Experience & Education, Operator Certification, September 2021
Page ii of iii
********************** How To Use Qualifications Tables below **********************
Paths A-E: Applicants may qualify for certification through different paths of experience and education.
Education (Ed):
• HS = valid high school diploma, transcript, GED certificate, or equivalent, documentation is required.
• Qualifying PHS Ed= Post-High School education in years: One year of post-high school education equals 45
qualifying Continuing Education Units (CEUs) or equivalent, or 45 quarter or 30 semester hours of qualifying
college or university credit. (HS + 1 = High School + 1 year of PHS Ed). Qualifying college degrees or credits
must be in the applied sciences fields (see Instructions for section E). Qualifying CEUs must be approved/
relevant to operator job tasks and required knowledge, and may be combined with qualifying college credits.
• Credits for on-the-job training may be used to meet education or experience, but not both.
Experience (Exp in years):
• Year(s) of experience in the routine performance of operator duties, tasks, and responsibilities at a domestic
wastewater collection or treatment system (may include operator intern or trainee if not also CWE). DEQ may
give partial credit for experience in a related field, as allowed by rule.
• Grade I: an approved Associate of Applied Science degree in water quality / wastewater technology may
substitute for 6 months experience; confirm in advance.
• Grades III and IV: a minimum amount of System Class operator experience is required.
• Provisional application requires all 3: current employment at a wastewater system, enrolled in DEQ-approved
training, being trained and supervised by a properly certified operator (See Instructions for more details).
System Class of the classified domestic wastewater collection system:
The system classification of where you earned your experience. Page 1 of the permit contains this classification, or
if no permit, the collection-only wastewater system is classified by population or number of connections. At least
half of the total experience must be no more than one grade lower than the certificate grade desired.
TREATMENT SYSTEM Operator Qualifications
Certif-
Path A
Path B
Path C
Path D
icate Level
HS or
Exp
Treatment
Qualifying
Exp
Treatment
Qualifying
Exp
Treatment
Qualifying
Exp
Treatment
Qualifying
(y)
System
PHS
(y)
System
PHS
(y)
System
PHS
(y)
System
PHS Ed
Class
Ed
Class
Ed
Class
Ed
Class
SWWS
HS
1
SWWS
Grade I
HS
1
I-IV
Provision-
SWWS-
HS
any
al I
IV
Grade II
HS
3
I-IV
1
2
I-IV
4y ≥ II
2y ≥ II
1.5y ≥ II
2.5y ≥ II
Grade III
HS
8
1
5
2
4
3
3
5y ≥ III
3y ≥ III
2y ≥ III
2.5y ≥ III
Grade IV
HS+1
10
2
6
3
5
4
4
COLLECTION SYSTEM Operator Qualifications
Certif-
Path A
Path B
Path C
Path D
Path E
icate
Ed Exp(y) System
Qualif-
Exp
Collec-
Qualif-
Exp
Collec-
Qualif-
Exp
Collec-
Qualif-
Exp
Collec-
Level
tion
tion
tion
tion
Class
ying
(y)
ying
(y)
ying
(y)
ying
(y)
System
System
System
System
PHS
PHS
PHS
PHS
Class
Class
Class
Class
Ed
Ed
Ed
Ed
SW
SWWS
HS
1
WS
Grade I
HS
1
I-IV
Provisional
SW
HS
any
I
WS-IV
Grade II
HS
3
I-IV
1
2
I-IV
4y ≥ II
2y ≥ II
2.5y ≥ II
1.5y ≥ II
Grade III
HS
8
1
5
2
4
3
3
5y ≥
4y ≥ III
3y ≥ III
2y ≥ III
2.5y ≥ III
Grade IV
HS
10
1
8
2
6
3
5
4
4
III
Oregon DEQ Instructions for Application, Post-Exam Experience & Education, Operator Certification, September 2021
Page iii of iii
DEQ USE ONLY
Mail application and fee to:
Oregon Department of Environmental Quality
Application for Post-Exam Supplemental
L2k Receipt #: __________
DEQ Business Office
Experience and Education For
Application #: __________
700 NE Multnomah Ave.,
Amount Received: ______
Wastewater System Operator Certification
Ste. 600
Date Received: _________
Portland, OR 97232-4100
Check #: _
_______________
OpCert phone: 503-229-5349
A. APPLICANT INFORMATION
Last Name:
First:
Middle :
Last four of SSN:
B. MAILING ADDRESS AND CONTACT INFORMATION
Address:
City, State, Zip:
Work Phone:
Home Phone:
Is this a change of mailing address?
Yes
No
email:
Current Employer:
C. APPLICATION CERTIFICATE TYPE (Do not use this application for a Provisional Grade I Certificate)
Applicants for Grades II, III, and IV certification must meet certificate education and experience qualifications within
four (4) months following the testing month. Grade I certificate applicants have 36 months to meet the education and
experience requirements after passing the Grade I exam(s). See Instructions.
Small Wastewater System (SWWS)
Wastewater Collection (WWC):
Grade I
Grade II
Grade III
Grade IV
Wastewater Treatment (WWT):
Grade I
Grade II
Grade III
Grade IV
D. POST-EXAM APPLICATION FEES
$50 (for one or two certificates)
Payment Receipt Requested
E. - F. SUPPLEMENTAL EDUCATION: College / Trade school / Continuing Education
If not already sent, attach proof of qualifying education and training (diplomas, college transcripts, certificates, or
letters of completion) showing that you now meet or exceed the minimum certification qualifications.
School Name / Location
Course or Major
# Credits
Certificate/Degree/Year
CEU / Course Name
Trainer/Vendor
# CEUs
Completion Date
Oregon DEQ Application for Post-Exam Supplemental Experience & Education for Operator Certification, September 2021
Page 1 of 3
G. WASTEWATER OPERATOR WORK EXPERIENCE HISTORY
Provide a detailed description of domestic wastewater operator duties and responsibilities for each segment of
work history. Include other related duties.
(attach copy of this page for additional prior jobs if necessary)
Current or Most Recent Experience – Job #1
Formal Job Title:
Average hours worked per week:
or current
From:
(mm/yyyy)
To:
(mm/yyyy)
Percentages below must sum to 100%.
%
WW Lab
WW Treatment
%
WW Collection
%
Drinking Water (Treatment, Distribution, Lab):
%
WW Pretreatment or Industrial WW
%
Stormwater Mgmt
%
Other Misc. Duties
%
Check all duties below that you cover:
WW Treatment System: Operate and Maintain = O and M
WW Collection System:
O and M Community septic, STEG, or STEP system
Installation, maintenance, inspection, repair of
O and M: Waste treatment lagoon / constructed wetlands
sewer lines / systems, test for leaks
O and M: Trickling filter or Rotating Biological Contactor system
Excavation, trenching / shoring, safe-digging
O and M: Activated sludge process
Line locating, clearing, hydro-washing, hydro-
O and M: Membrane Bioreactor treatment system
vacuuming, televising, flushing
O and M: Bar screen, comminutor, grit chamber
Use / repair equipment and tools
O and M: Aeration basins, primary and secondary clarifiers
Lift / pump station inspect / test / maintain / repair
O and M of dissolved air flotation (DAF)
Diagnosing / troubleshooting motors / valves /
O and M of primary and / or tertiary filters
equipment / pumps
Diagnosing / troubleshooting pumps / motors / valves / equipment
Work safely in confined spaces
Preventive or corrective maintenance of plant equipment
Inflow and infiltration analysis or reporting
Collect process control samples, interpret results
Sanitary Sewer Overflow reporting
Make plant process control decisions based on results
Interpreting blueprints, schematics, GIS tools
Take plant readings (e.g. flow, power, pressure, chemical)
Evaluate / monitor / improve system performance
Measure influent / effluent and / or RAS and WAS parameters
Prepare other system reports, records, policies,
Operate, monitor, adjust effluent disinfection e.g. chlorination,
procedures, manuals, asset management
dechlorination, UV, ozone
Wastewater Lab:
O and M: sludge digester
Monitor wastewater, effluent, and sludge quality
O and M: sludge dewatering process
Organics testing - BOD, BOD5, COD, TOC, etc.
O and M of digester gas / re-use / co-generation
Bacteria / coliform testing
Adjust polymer feed rates
Solids sampling - TS, TSS, VSS, MLSS, etc.
Disposal of sludge or effluent: biosolids handling, hauling, land
Testing for: temperature, chlorine residual,
apply, and / or effluent re-use
conductivity, pH, DO, volatile acids, alkalinity
Operate, interpret, monitor SCADA system
Quality assurance and control / instrument
Review and interpret operational records for possible problems
calibrations, SOP
Prepare regulatory reporting documents
Other lab tests, sampling, documentation
Prepare other facility reports, policies, procedures, manuals
Other Systems Management
Industrial wastewater
Stormwater system
Drinking Water system
Applicant’s Description of routine duties and other duties not listed above
:
Employer Name:
System Name:
System Address:
Permit #:
City:
State:
Zip Code:
System Type and Classification Level:
Designated System Supervisor” ( the designated supervising system
operator on record with DEQ):
email:
System Supervisor Phone Number:
Oregon DEQ Application for Post-Exam Supplemental Experience & Education for Operator Certification, September 2021
Page 2 of 3
Page of 6