Get Ia Dnr Form 542-3119 2021-2025

Completing the IA DNR Form 542-3119 online is a crucial step for effective water and wastewater operator certification. This guide provides clear and structured instructions to help users navigate the form confidently and accurately.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the online version of the IA DNR Form 542-3119. This will open the form in your preferred editing tool.
2. In the 'Certified Operator Completes' section, enter the operator's name, certification number, address, expiration date, city, state, phone, email, and zip code. Choose the certificate type and grade related to water treatment, water distribution, wastewater treatment, and wastewater lagoon as applicable.
3. In the 'Owner/Representative of Facility Completes' section, fill in the facility name and address, along with the county, city, state, phone, email, and zip code. Check the boxes for the facility type and grade.
4. Complete the 'Additional Information Regarding Facility Operation and Maintenance' section. Provide the Water Supply PWSID number and Wastewater NPDES number where applicable. List the names, cell phone numbers, and emails of those responsible for daily activities and compliance.
5. Describe the roles and responsibilities of the personnel listed. Include details about training and procedure for emergency situations.
6. In the 'Affidavit of Operator' section, type or print the operator's name, title, and date. Ensure the operator's signature is provided and includes notarization.
7. Complete the 'Affidavit of Owner/Representative' with the owner's printed name, title, signature, and date. Notarization must also be provided for this section.
8. Review all entries for accuracy and completeness. Once satisfied, you can save the changes, download, print, or share the completed form as needed.

Take action now and fill out the IA DNR Form 542-3119 online to ensure compliance with Iowa regulations.