DDW-2025-001853

pg 1 of 1 - revised 7/23/2019
Division of Drinking Water
Operator Certification Program
195 North 1950 West P.O. Box 144830
Salt Lake City, Utah 84114-4830
Phone: [phone] E-mail: [e-mail]
DDWOpCert.utah.gov
Utah Division of Drinking Water Water Operator Certificate RENEWAL APPLICATION
Checklist Instructions:
☐Step 1 Check if you have enough CEUs to renew before filling out this application.
 https://waterlink.utah.gov/deqWater/public/ceuReport.html
☐Step 2 Fill out this application form completely.
☐Step 3 Pay a fee for each certificate and include your name.
 https://deq.utah.gov/drinking-water/dw-payment-portal#opcert
Order#:
☐Step 4 Send the application and fee (or fee receipt) to the Division of Drinking Water via email or postal mail (info in box).
CERTIFICATE
PERSONAL INFORMATION
First, Middle, Last Name (Mr. or Ms.): Certification #:
Email address: Date of Birth:
Home Address: Cell phone:
City: State: Zip: Home phone:
CURRENT EMPLOYMENT
Employer/Water System:
Are you a regional operator? ☐Yes ☐No Water System#s:
Email: Phone:
Operator's Signature Date:
"By signing, I certify the above information is correct and complete.
I understand that all info might be verified by Drinking Water Staff."
Other Applications available online:
Unrestricted Status – Apply for unrestricted status upon accumulating the necessary experience.
☐Renewal - $180
less than 6 months past expiration
☐Reinstatement - $360
more than 6 months and less than 18 months past expiration
Distribution Grade level (SS,1,2,3,4):________ Expiration Year:_________
Treatment Grade level (1,2,3,4):__________ Expiration Year: _________
Distribution Grade level (SS,1,2,3,4):________ Expiration Year:_________
Treatment Grade level (1,2,3,4):__________ Expiration Year: _________
DDW Office Use Only
Received Scanned ☐
SDWIS ☐
CEUs ☐
Fee ☐
Renewal Year