REGULATIONS
Vol. 38 Iss. 19 - May 09, 2022

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD FOR WATERWORKS AND WASTEWATER WORKS OPERATORS AND ONSITE SEWAGE SYSTEM PROFESSIONALS
Chapter 30
Forms

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING

BOARD FOR WATERWORKS AND WASTEWATER WORKS OPERATORS AND ONSITE SEWAGE SYSTEM PROFESSIONALS

Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Titles of Regulations: 18VAC160-30. Waterworks and Wastewater Works Operators Licensing Regulations.

18VAC160-40. Onsite Sewage System Professionals Licensing Regulations.

Agency Contact: Joseph Haughwout, Department of Professional and Occupational Regulation, 9960 Mayland Drive, Suite 400, Richmond, VA 23233, telephone (804) 367-2684, or email joseph.haughwout@dpor.virginia.gov.

FORMS (18VAC160-30)

Waterworks Operator License Application, A436-1955EXLIC-v1 (eff. 4/2017)

Provisional Waterworks Operator License Application, A436-1955PLIC-v2 (eff. 4/2017)

Wastewater Works Operator License Application, A436-1965EXLIC-v2 (eff. 4/2017)

Provisional Wastewater Works Operator License Application, A436-1965PLIC-v2 (eff. 4/2017)

Waterworks and Wastewater Works Operator - Provisional License Change in Classification Application, A436-1955_65CHG-v1 (eff. 4/2017)

Waterworks Operator License Application, A436-1955EXLIC-v2 (eff. 12/2021)

Provisional Waterworks Operator License Application, A436-1955PLIC-v3 (eff. 12/2021)

Wastewater Works Operator License Application, A436-1965EXLIC-v3 (eff. 12/2021)

Provisional Wastewater Works Operator License Application, A436-1965PLIC-v3 (eff. 12/2021)

Waterworks and Wastewater Works Operator - Provisional License Change in Classification Application, A436-1955_65CHG-v2 (eff. 12/2021)

Out-of-State Facility Description and Experience Verification Application, A436-19STATE_EXP-v3 (eff. 4/2015)

Waterworks and Wastewater Works Operator Virginia Experience Verification Application, A436-19WWEXP-v4 (eff. 4/2017)

Provisional Description and Experience Verification Application, A436-1955_65PEXP-v3 (eff. 12/2014)

Continuing Professional Education (CPE) Application - Certificate of Completion, A436-19CPE-v3 (eff. 10/2015)

Training Course Approval Application, A465-19CRS-v5 (eff. 2/2020)

Education and Training Substitution Form, A436-19EDTRv4, (eff. 4/2017)

Wastewater Works Operator Class 4 Application - Department of Corrections Apprenticeship Program, A436-1965APLIC-v3 (eff. 6/2019)

FORMS (18VAC160-40)

Conventional Onsite Soil Evaluator License Application, A465-1940CONLIC-v1 (eff. 4/2017)

Alternative Onsite Soil Evaluator License Application, A465-1940ALTLIC-v1 (eff. 4/2017)

Conventional Onsite Sewage System Installer License Application, A465-1944CONLIC-v1 (eff. 4/2017)

Alternative Onsite Sewage System Installer License Application, A465-1944ALTLIC-v1 (eff. 4/2017)

Conventional Onsite Sewage System Operator License Application, A465-1942CONLIC-v1 (eff. 4/2017)

Alternative Onsite Sewage System Operator License Application, A465-1942ALTLIC-v2 (eff. 4/2018)

Waiver of Examination - Master Conventional Onsite Sewage System Operator License Application, A436-1942WAIV-v2 (eff. 4/2017)

Conventional Onsite Soil Evaluator License Application, A465-1940CONLIC-v2 (eff. 12/2021)

Alternative Onsite Soil Evaluator License Application, A465-1940ALTLIC-v2 (eff. 12/2021)

Onsite Soil Evaluator Experience Verification Application, A436-1940EXP-v1 (eff. 11/2021)

Conventional Onsite Sewage System Installer License Application, A465-1944CONLIC-v2 (eff. 12/2021)

Alternative Onsite Sewage System Installer License Application, A465-1944ALTLIC-v2 (eff. 12/2021)

Conventional Onsite Sewage System Operator License Application, A465-1942CONLIC-v2 (eff. 12/2021)

Alternative Onsite Sewage System Operator License Application, A465-1942ALTLIC-v3 (eff. 12/2021)

Waiver of Examination - Master Conventional Onsite Sewage System Operator License Application, A436-1942WAIV-v3 (eff. 12/2021)

Onsite Sewage System Operator/Installer Experience Verification Application, A436-1942_44EXP-v1 (eff. 11/2021)

Continuing Professional Education (CPE) Application - Certificate of Completion, A436-19CPE-v3 (eff. 10/2015)

Training Course Approval Application, A465-19CRS-v5 (eff. 2/2020)

Education and Training Substitution Form, A436-19EDTRv4 (eff. 4/2017)

Onsite Sewage System Applicant Experience Verification Application, A436-19OSSPEXP-v4 (eff. 4/2017)

VA.R. Doc. No. R22-7126; Filed April 15, 2022