Get Min Staffing Request Form.doc - Epa State Oh

This guide provides a step-by-step approach to completing the Min Staffing Request Form for the Ohio Environmental Protection Agency. By following these instructions, users will be able to efficiently fill out the necessary information online.

Follow the steps to complete your Min Staffing Request Form.

1. Press the ‘Get Form’ button to access the Min Staffing Request Form and open it in your preferred editor.
2. In the 'Applicant' section, provide the facility name, mailing address, city, state, and zip code. Ensure all information is accurate to avoid delays.
3. Fill out the contact information for the facility, including the facility contact's name, title, phone number, fax number, and email address.
4. Under 'Facility Information,' enter the PWS ID number and classify the facility as Class II, III, or IV.
5. List the Operator of Record(s) and their corresponding certification numbers. If there are backup operators, include their certification numbers as well.
6. Refer to Table A for Staffing Level Reduction Options, and select the appropriate classification option while detailing the hours and days for operator availability.
7. If applicable, complete Table B regarding Automation or Continuous Monitoring Level Reduction options by choosing the relevant classification and detailing the hours.
8. Designate options used to determine total hours requested for both staffing levels and automation monitoring.
9. In the signature section, provide your signature and the date to affirm the details provided.
10. Finally, save any changes made, and ensure to download, print, or share the completed form as required.

Take the next step in ensuring compliance by filling out your forms online today.