HomeMy WebLinkAbout312419 06/13/17 CITY OF CARMEL, INDIANA VENDOR: 00351805
s ONE CIVIC SQUARE IN DEPT OF ENVIRONMENTAL MGMT CHECK AMOUNT: $"'"*'""30.00'
CARMEL, INDIANA 46032 100 N SENATE AVENUE CHECK NUMBER: 312419
MAIL CODE 66-34 CHECK DATE: 06/13/17
INDIANAPOLIS IN 46204-2251
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 8024286 30.00 OTHER EXPENSES
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IDEM Indiana Department of Environmental Management
100 N.Senate Avenue Invoice NuCber: 8024286
Mail Code 66-34 Renewal F0Indianapolis,IN 46204-2251Money Re
(Office Only)
May 18, 2017 Certificate Number: DS 120002
Anthony W. Isenberger 000946 Expiration Date: 06/30/2017
Grade: DSL
6212 Buttonwood Dr. Obtained By: Examination
Noblesville IN 46062
Login ID: DS 120002
Password: 1279627
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Water Works Operator Certification Renewal Fee Statement
Our records indicate your Water Works Certificate No. DS 120002, 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 38.00 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.
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 DELIVERED JUN 0 2 Y017
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