Doh 352 2011 form-2025

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The document is an application form for the renewal of certification for water treatment plant or distribution system operators issued by the New York State Department of Health. It includes instructions for completing the application, requirements for submitting training credits, and emphasizes the importance of providing complete information to avoid rejection.

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Begin by filling out SECTION I, which includes your personal information. Ensure you provide your phone numbers, email address, employer name, and address clearly.
Next, move to SECTION II for Renewal Training Credits. List all training courses completed in the past three years. For each course, include the subject, dates attended, contact hours, location, and sponsor.
After completing both sections, review your entries for accuracy. Remember to print in pen or type all information as specified.
Finally, sign and date your application at the bottom of the second page. This step is crucial; failure to sign will result in rejection of your application.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (82 Votes)
2012	4.4 Satisfied (552 Votes)
2011	4 Satisfied (34 Votes)

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