Collection Systems Certification Application

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NEWEA - New England Water Environment Association > Collection Systems Certification Application

Collection Systems Application

Please note that this application must be completed at one time. There is no option to save. Required fields are noted with a red *.

Step 1 of 5

20%

Name (as it appears on your license/ID)*
First Middle Last
Mailing Address:*
Street Address Address Line 2 City State ZIP Code
Best Number to reach you*
Email (please enter the email you would like your exam voucher to be sent)*
Are you physically capable of performing the duties of an operator in the grade for which you are applying?
- Yes
- No
Are you ReTesting (taking the same grade level for a better score)?*
- Yes
- No
If "yes", what Grade Level?*

EDUCATION & TRAINING
Did you attend High School?*
- Yes
- No
Last Grade Completed
Did you graduate from High School?*
- Yes
- No
If yes, list your graduation year.
If yes, list the location of the school
Did you obtain your GED?*
- Yes
- No
If yes, list your graduation year.
If yes, list the location of the school
Did you attend a College or University?*
- Yes
- No
List Dates Attended
List your Major
Credit or Degree Obtained
Date of Leaving or Graduating
Did you obtain a secondary degree from a College or University?
- Yes
- No
List Dates Attended
List your Major
Credit or Degree Obtained
Date of Leaving or Graduating
List other educational courses completed such as vocational school, correspondence, armed services, specialized courses, operators’ short courses, business school, etc. Give date, name and duration of course and name of school or sponsoring organization.

EXPERIENCE
Name of the wastewater collection system*
Give your title*
Give a detailed description of the duties you perform at your present position as they relate to wastewater collection systems*
Are you in responsible charge?*
- Yes
- No
If not, to whom do you report?
How long have you held your present position?*
List in detail all positions you have held in the past 5 years as they pertain to wastewater collection systems*
Start Date End Date Employer and Location Describe in detail all duties List who you reported to

Give a detailed description of your job indicating SPECIFIC DUTIES (i.e. operate a high velocity cleaner, CCTV system, inspect pump stations, respond to blockages & odor complaints, etc.) If you have held the same position for the past 5 years, please describe previous work experience. Use the + sign to add more rows.

Classification of Wastewater Collection Systems
The point system is based on the 13 areas described in Section 9.2 of the brochure. Grade I: 1 - 21 Grade II: 21 - 39 Grade III: 40 - 55 Grade IV: 55 - >
1. Largest Pipe Size (diameter in inches)*
- Up to 42"
- Greater than 42"
2. Average Total Flow MGD*
- 0 - 0.10
- 0.10 - 0.40
- 0.40 - 0.70
- 0.70 - 1.00
- 1.0 - 5.0
- 5.0 - 10.0
- 10.0 - 20.0
- 20.0 - 50.0
- 50.0 - 100.0
- 100.0 >
Do you have industrial flow in excess of 20% of total flow?*
- Yes
- No
Hidden
Industrial flow in MGD
3.. Total Miles of Sewer Sanitary & Combined. Do not include storm sewers.*
- 0 - 10
- 10 - 20
- 20 - 50
- 50 - 100
- 100 >
4. Pump Stations Under Control of Collection Systems Operators
a. Standby power*
- Yes
- No
b. Dry well station*
- Yes
- No
c. Wet well station*
- Yes
- No
d. Grit removal*
- Yes
- No
e. Comminution*
- Yes
- No
f. Bar rack*
- Yes
- No
g. Aeration*
- Yes
- No
h. Variable speed pumps*
- Yes
- No
i. Number of stations*
- 2-4
- 5-10
- 10 >
Hidden
j1. Number of alarm systems
- 1
- 2-4
- 5-10
- 10 >
j. Alarm systems
- Select All
- Flow
- Personal Safety
- telecommunications
5. Flow Measurement in Collection Systems**
- Yes
- No
6. Siphons*
- Yes
- No
7. Combined Sewers*
- Yes
- No
8. Force Main*
- Yes
- No
9a. Chemical Additions - Hypochlorite*
- Yes
- No
9b. Chemical Additions - Gas*
- Yes
- No
9c. Chemical Additions - Other*
- Yes
- No
Chemical Additions - Other (explain)
10. Odor Control System*
- Yes
- No
11. SCADA System*
- Yes
- No
12. Oldest Part of System*
- Prior 1940
- Prior 1960
- Prior 1980
- New
13. Mechanical Equipment
a. High Pressure jet truck*
- Yes
- No
b. Mechanical rodder*
- Yes
- No
c. Bucket Machine*
- Yes
- No
d. Combination vacuum/jet truck*
- Yes
- No
e. Closed circuit TV equipment*
- Yes
- No
f. High pressure grouter*
- Yes
- No
g. Other (be specific)
14. Population Served by System*
- 1,500 or less
- 1,501-15,000
- 15,001-50,000
- 50,001 and greater
15. Does the collection serve:*
- Municipality
- Industry
- Institution
- Other
If "other" please explain
16. Do the wastes received in your system present unusual problems? If so, explain:

Do you currently hold a NEWEA issued Collection Systems Certification?*
If "yes", list grade level and date of issue
Are you seeking Reciprocity to NEWEA regarding your certification/license from another state/organization?*
- Yes
- No
If "yes", what state, grade and date of issue?
If not currently employed in a collection system, why do you consider yourself qualified for certification?
Please review the Collection Systems Brochure and select the grade of operator certification for which you qualify*
REFERENCES
Give names and phone numbers of at least two persons, not relatives, who have knowledge of your character, experience, and ability.
List your first reference's name and phone number*
List your second reference's name and phone number*
Agreement*
I hereby certify that this application contains no willful misrepresentations or falsifications, and that the information given by me is true and complete to the best of my knowledge and belief. I further agree to abide by the provisions of the Certification Program of the New England Water Environment Association, Inc.
- I agree
Acknowledgement*
I hereby acknowledge that this application is complete and contains all pertinent information related to obtaining my Collection Systems Certification. I further acknowledge that once the review process is complete, if there is any additional information I wish to add I will need to fill out a new application, including the applicable fee.
- I acknowledge
PAYMENT
Application Fees*
Total
$0.00
Payment Method*
- Credit Card
- Purchase Order/Send Check
Purchase Order/Check #*
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Please hit submit ONCE and be patient. If you hit submit multiple times, you will be charged multiple times.

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Start Date	End Date	Employer and Location	Describe in detail all duties	List who you reported to

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Collection Systems Application

Step 1 of 5

EDUCATION & TRAINING

EXPERIENCE

Classification of Wastewater Collection Systems

4. Pump Stations Under Control of Collection Systems Operators

13. Mechanical Equipment

REFERENCES

PAYMENT

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