New jersey notification form 2025

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The document is a Licensed Operator in Charge Employment Notification Form for wastewater facilities issued by the New Jersey Department of Environmental Protection. It requires applicants to provide personal and facility information, confirm their role as the operator in charge, and detail their availability. The form must be completed fully for processing, and any employment changes should be reported two weeks in advance.

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Click ‘Get Form’ to open the New Jersey Notification Form in the editor.
Begin by filling out Section I, which includes your name, facility name, and contact information. Ensure that all phone numbers are accurate for effective communication.
In Section II, indicate whether this is a request to be the operator in charge or a notification of termination. If you are notifying of termination, skip Sections III and IV.
Complete Section III by answering whether you have evaluated the facility and how many hours per week or month you will devote to operations. Provide details of licensed individuals responsible during your absence.
Finally, in Section IV, ensure an authorized representative from the requesting facility signs off on the form, confirming their acknowledgment of your role.

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2016	4.8 Satisfied (120 Votes)
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