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Home My WebLink About312021 5/31/2017 ♦0 S�qM CITY OF CARMEL, INDIANA VENDOR: INDIAN 05 CHECK AMOUNT: $ ..."450.00" ONE CIVIC SQUARE INDIANA DEPT OF ENVIR MGT rq; CARMEL, INDIANA 46032 100 N SENATE AVE,PO BOX 6015 CHECK NUMBER: 312021 PO BOX 6015 CHECK DATE: 05/31/17 �'�iroN c° INDIANAPOLIS IN 46206-6015 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 8023890 30.00 OTHER EXPENSES 601 5023990 8023894 30.00 OTHER EXPENSES 601 5023990 8024002 30.00 OTHER EXPENSES 601 5023990 8024181 30.00 OTHER EXPENSES 601 5023990 8024285 30.00 OTHER EXPENSES 601 5023990 8024287 30.00 OTHER EXPENSES 601 5023990 8025390 30.00 OTHER EXPENSES 601 5023990 8025559 30.00 OTHER EXPENSES 601 5023990 8025618 30.00 OTHER EXPENSES 601 5023990 8025854 30.00 OTHER EXPENSES 601 5023990 8025879 30.00 OTHER EXPENSES 601 5023990 8025926 30.00 OTHER EXPENSES 601 5023990 8026051 30.00 OTHER EXPENSES 601 5023990 8026138 30.00 OTHER EXPENSES 601 5023990 8026152 30.00 OTHER EXPENSES co N .0 E N E m O 00 69 U- 0 O � U W D — m O Z i- Q Q h 0 8S � F- F- 0 M m C7 z � w N Q J N Q y- 4 U N Z N L o M `= 3 M N a LU co U _ : _ s a m V- O M Z LL Q o rnt U) jj 0 od N N > > z GO Z N Lo UJ -_ Q z \ p p ci v o' O Cr) app O O \ to° bo o > o Z Z a \ U IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Num r: 8025618 �� Mail Code 66-34 Renewal F 30.00 Indianapolis,IN 46204-2251 Money R ceipt (Office On May 18,2017 Certificate Number: WT057974 Jaimie L.Foreman 002094 Expiration Date: 06/30/2017 Grade: WT3 4915 E. 106th Street Obtained By: Examination Indianapolis IN 46280 Login ID: WT057974 Password: 582485 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT O.W Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WT057974, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 66.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and b renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. s Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.go_v. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. P I Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return g this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE r DELIVERED MAY 2 6 2017 (1) IDEM Indiana Department of Environmental Management r""1 100 N.Senate Avenue Invoice Num : 8026152 Mail Code 66-34 Renewal Fee 30.00 `C Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: WT 140192 Matthew G.Bickel 002314 Expiration Date: 06/30/2017 Grade: WT5 724 Bluff Creek Drive Obtained By: Examination Fortville IN 46040 Login ID: WTI 40191 Password: 1781467 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WTI 40192, Grade WT5 for a class WT5 Water Treatment Plant expires on June 30, 2017. You are required to obtain 30.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 42.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, a s and you will have to retest. s Online Renewal —Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal —To renew through the mail, please fill out the section on the back of this page and return 8 this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE c DELIVERED MAY 2 610® (1) IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice NCe: 3DO.00 603 Mail Code 66-34 Renewal Indianapolis,IN46204-2251 Money Re (Office Only) May 18,2017 Certificate Number: WT 140191 Matthew G.Bickel 002313 Expiration Date: 06/30/2017 Grade: WT3 724 Bluff Creek Drive Obtained By: Examination Fortville IN 46040 Login ID: WT 140191 Password: 1781467 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Iti Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WT140191, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 42.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. s Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return 8 this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) _ $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 DELIVERED MAY 2 6 2017 SEE FORM ON OTHER SIDE (1) IDEM Indiana Department of Environmental Management //� ,{ 100 N.Senate Avenue Invoice Numb : 8025390 (Q(/�� Mail Code 66-34 Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18, 2017 Certificate Number: WT007785 Daniel R.Jenkins 001679 Expiration Date: 06/30/2017 Grade: WT3 12672 Strawtown Ave. Obtained By: Examination Noblesville IN 46060 Login ID: WT007785 Password: 578507 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certircation Renewal Fee Statement Our records indicate your Water Works Certificate No. WT007785, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 35.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, a s and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://myticense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return g this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE DELIVERED MAY 2 6 2V (1) IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Num r: 8026051 �!/J Mail Code 66-34 Renewal Fee: 30.00 ` Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: WT150049 William A. Bell Jr 002375 Expiration Date: 06/30/2017 Grade: WT5 5419 South 225 West Obtained By: Examination Atlanta IN 46031 Login ID: WTI 50049 Password: 582707 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WTI 50049, Grade WT5 for a class WT5 Water Treatment Plant expires on June 30, 2017. You are required to obtain 30.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 24.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and a renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. Online Renewal —Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return s this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 J DELIVERED MAY 2 6 2W SEE FORM ON OTHER SIDE (1) N N cc O m 64 r U- OLU 0 � o � U O Z J Q Q H I- cc 0 z Z g U. O g LO o aCV Q w Q Q CNQ fn M Q o ofKl .-.. Z N L a M E cv ` NF- m In CL p q ti Z Z ¢ r O M V6 d O O O O OST' F- N > coJ EN > ZWQ a. Z �# � � O moo "s- LU 6° `N w U) a /�� o Z M � o � m � n � ' OH' OQ V () a 'J a V coaUZ Q co y ca i. O Lf) Q ¢ Q O ' > o ? ? a Indiana Department of Environmental Management 100 N.Senate Avenue Invoice N ber: 8 25854 r„ OM Mail Code 66-34 Renewal e: 30.00 lS� Indianapolis,IN 46204-2251 Money Receipt (Office Only) May 18,2017 Certificate Number: WT 110146 Expiration Date: 06/30/2017 Kris C.Anthis 002227 Grade: WT3 6455 W.Whispering Way N. Obtained By: Examination Greenfield IN 46140 Login ID: WT 140185 Password: 811758 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement {-dC Our records indicate your Water Works Certificate No. WTI 10146, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 59.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, a g and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. 8 Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return g this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) IDE 1 Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Number- 023891 Mail Code 66-34 Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: DS007817 Daniel R.Jenkins 00001? Expiration Date: 06/30/2017 Grade: DSL 12672 Strawtown Ave. Obtained By: Examination Noblesville IN 46060 Login ID: WT007785 Password: 578507 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. DS007817, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 35.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and $ renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, b g and you will have to retest. s Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) ID 1 Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Na : 8025559 Mail Code 66-34 Renewal Fe Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: WT947019 Jerry A.Cloud 002591 Expiration Date: 06/30/2017 Grade: WT3 19560 Wind Wood Pkwy. Obtained By: Examination Noblesville IN 46062 Login ID: WT947019 Password: 581424 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT { Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WT947019, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 43.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are $ not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and s renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. s Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. g Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return $ this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Numb 0— Money Mail Code 66-34 Renewal Fee: Indianapolis,IN 46204-2251 Receipt (Office Only) May 18,2017 Certificate Number: DS007769 Jerry A.Cloud 0 0 0 0 0 2 Expiration Date: 06/30/2017 y Grade: DSL 19560 Wind Wood Pkwy. Obtained By: Examination Noblesville IN 46062 Login ID: WT947019 Password: 581424 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. DS007769, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 43.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are gnot a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and $ renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s s and you will have to retest. s Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) IDEM Indiana Department of Environmental Management 40 100 N.Senate Avenue Invoice Number: 26138 Mail Code 66-34 Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: WT 140185 Kris C. Anthis 002311 Expiration Date: 06/30/2017 Grade: WT5 6455 W.Whispering Way N. Obtained By: Examination Greenfield IN 46140 Login ID: WTI 40185 Password: 811758 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WT140185, Grade WT5 for a class WT5 Water Treatment Plant expires on June 30, 2017. You are required to obtain 30.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 59.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. s Online Renewal —Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. 8 Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return g this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Numbe . 8025879 rr,^, Mail Code 66-34 Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt (Office Only) May 18,2017 Certificate Number: WT120013 Andrew R.Creasy 002267 Expiration Date: 06/30/2017 Grade: WT3 1511 W.Division Rd. Obtained By: Examination Tipton IN 46072 Login ID: WTI 20013 Password: 1277539 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WTI 20013, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2017. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 39.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are $ not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and srenew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, a s and you will have to retest. g Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. g Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice umber: 8023894 /n Mail Code 66-34 Renewal ee: 30. CSD S Indianapolis,IN 46204-2251 Money Receipt# (Office Only) May 18,2017 Certificate Number: DS008461 BRETT R. RANSFORD 000059 Expiration Date: 06/30/2017 Grade: DSL 12554 Lantern Road Obtained By: Examination Fishers IN 46038 Login ID: DS008461 Password: 578529 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certilcation Renewal Fee Statement Our records indicate your Water Works Certificate No. DS008461, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 53.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal —To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) IDEM Indiana Department of Environmental Management / m 100 N.Senate Avenue Invoice Numb r: 80 4285 6 ' Mail Code 66-34 Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt (Office Only) May 18, 2017 Certificate Number: DS 110167 Shawn F.Cooksey 0 0 0 8 81 Expiration Date: 06/30/2017 y Grade: DSL 2907 East 186th St. Obtained By: Examination Westfield IN 46074 Login ID: DS 110167 Password: 1279623 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement r Our records indicate your Water Works Certificate No. DS 110167, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 37.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, g and you will have to retest. s Online Renewal —Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.g_ov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1) L E E a 0 m q Q Q � o � � O o p o zcn LLO U-) o a " J N F- 04 g ,� H o a , 3 Z N O W cow JoecNu s N d aU o ON ZMz � Q o (� co c� Z O > CO J E ~ N zW0 L o -' o c Z = c�oa � Z V v Go o CL U WJQ Q `� v � D M D — 0 Z 0 m a Z m z O a U v loo 1 Indiana Department of Environmental Management 100 N.Senate Avenue Invoice Nu er: 8024090 Mail Code 66-34 Renewal F 30.00 Indianapolis,IN 46204-2251 Money Receipt (Office Only) May 18,2017 Certificate Number: DS987929 GREG H. HOLLANDER 001626 Expiration Date: 06/30/2017 Grade: DSL 3450 WEST 131ST ST. Obtained By: Examination Westfield IN 46074 Login ID: DS987929 Password: 582980 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT a * Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. DS987929, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 32.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, s and you will have to retest. Online Renewal —Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return 8 this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (I) IDEM Indiana Department of Environmental Management 100 N.Senate Avenue Invoice N ber: 8024181 Mail Code 66-34 Renewal ee: 30.00 Indianapolis,IN 46204-2251 Money Receipt (Office Only) May 18,2017 Certificate Number: DS987856 STEVE L.COOK 001604 Expiration Date: 06/30/2017 Grade: DSL 3450 WEST 131 ST STREET Obtained By: Examination Carmel IN 46074 Login ID: DS987856 Password: 583445 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. DS987856, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 35.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, g and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.-ov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return 8 this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in 8 spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (t) IDEM Indiana Department of Environmental Management / 100 N.Senate Avenue InvoiceLFee: :30.00 024287 Mail Code 66-34 Renewa Indianapolis,IN 46204-2251 Money (Office Only) May 18,2017 Certificate Number: DS 120079 Matthew D.McNulty 001003 Expiration Date: 06/30/2017 Grade: DSL 3450 West 131 st Obtained By: Examination Westfield IN 46074 Login ID: DS 120079 Password: 1279629 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ' Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. DS 120079, Grade DSL for a class DSL Water Distribution System expires on June 30, 2017. You are required to obtain 15.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 48.00 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of 8 hours, you need to attend courses prior to June 30, 2017. After this date you are on expired status and are $ not a valid certified operator. You do have until June 30, 2018 to get your continuing education hours and renew your certification. Failure to renew by June 30, 2018 will result in termination of your certification, a s and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mylicense.in.gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, & Discover credit and debit cards. Login ID and Password are listed above. sMail Renewal—To renew through the mail, please fill out the section on the back of this page and return 8 this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take 8 longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 100 N. Senate Avenue Indianapolis, IN 46204-2251 SEE FORM ON OTHER SIDE (1)