173113 05/28/2009 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL MS T T�
e CARMEL, INDIANA 46032 MAIL CODE 65112 �t1 AMOUNT: $30.00
o
100 N SENATE AVE CHECK NUMBER: 173113
INDIANAPOLIS IN 46204 -2251
CHECK DATE: 5/28/2009
DEPA RTMENT T ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT D ESCRIPTIO N W
1 601 502399Q 11519 30.00 OTHER EXPENSES
Indiana'/ epartment of Environmental Management
100 N. Senate Avenue IDEM
Mail Code 65-42
Indianapolis, IN 46204 -2251
EST
1986
April 30, 2009
Robert O. Lovell
19156 Allisonville Road
Noblesville IN 46060
WASTEWATER TREATMENT PLANT OPERATOR RENEWAL APPLICATION
Certification WW011519
Expiration Date: 06/30/2009
Renewal Fee: $30.00
Login Id: WW011519
Password: 492134
Current Continuing Education Hours Earned: General 15.00 Technical 6.50 Total 21.50
1 am the responsible char e operator of: Hours/Week Permit Cit
Address Change:
Current Phone 7
7 Operator Signature: I/7 y pate: j
Your wastewater treatment plant operator certification expires 0613012009. After this date, you cannot be the operator
in responsible charge of a wastewater treatment plant until your certification is renewed.
You must meet the continuing education requirement as shown below:
Classes I -SP, A -SO 5 hours earned between 7/1/2007 6/30/2009 from IDEM approved course with at feast 3.5 of
those hours from courses designated as "technical."
Classes I, 11, A, B 10 hours earned between 7/1/2007 6/30/2009 from IDEM approved course with at least 7 of
those hours from courses designated as "technical."
Classes III, IV, C, D 20 hours earned between 7/1/2007 6/30/2009 from IDEM approved course with at feast 14 of
those hours from courses designated as "technical."
Online Renewal Online renewal is available 24 hours a day, 7 days a week between May 1, 2009 and July 1, 2009 at
httgs: /extra net. in.nov /mvlicense The cost for the online renewal is $30.00 plus an additional $4.17 in processing fees. The
forms of payment accepted online are Visa, Mastercard, Discover credit and debit cards. Login ID and Password are listed
above.
Mail Renewal If you wish to renew by mail, fill out the responsible charge information, and send this form with your $30
renewal fee to: Cashier— Mail Code 50-10C, Indiana Dept. of Environmental Management, 100 N. Senate Avenue,
Indianapolis, IN 46204 -2251
Should you have any questions or concerns about the renewal process, please contact Tonja Fuller -White at (317) 233 -0479
or by e-mail at tfullerw@idem.in.Qov
VOUCHER 091832 WARRANT# ALLOWED
TIDEM ��..,,rr IN SUM OF
ICS M �r C VO
140 N SENATE AVENUE r
INDIANAPOLIS, IN 46204 225 RK%'
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
WW011519 01- 6040 -03 $30.00
Voucher Total $30.00
C st distribution ledger classification if
cl im paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
T
An invoice or bill to be properly itemized must show, kind of service, where)
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
TIDEM
IDEM Purchase Order No.
100 N SENATE AVENUE Terms
INDIANAPOLIS, IN 46204 -2251 Due Date 5/18/2009
Invoice Invoice Description
Date Number. (or note attached invoice(s) or bill(s)) Amount
5/18/2009 WVV011519 $30.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date O r