Onondaga County, NY · Onondaga County
On-Site Assessment of Water Treatment Plant and Distribution System Operator
This assessment form records an operator’s knowledge and performance for water treatment plants and distribution systems, and is completed by the operator and assessor.
At a glance
- Issued by
- City of Onondaga County · Onondaga County, Onondaga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- onondaga.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The form guides an on-site assessment of a water treatment plant or distribution system operator, covering system operation, maintenance, monitoring, emergencies, regulations, and laboratory skills. It records the operator’s name, certification grade, assessment date and times, system details, satisfactory or unsatisfactory results, and any recommendations. A completed form may accompany DOH-354, an Application for Certification.
Who needs it
Water system operators and assessors use this form to document an on-site assessment and any certification grade recommendation.
How to submit it
A completed form may accompany DOH-354, Application for Certification. Submit it to the county department named on the form; check the county website for current contact details.
About notarization
This document is signed and dated without a notary; it does not describe any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download the Assessment Form
Download the On-Site Assessment of Water Treatment Plant and Distribution System Operator form.
- 2
Complete the Assessment
Enter the operator and water system information, then record assessment results and any recommendations.
- 3
Gather Related Application
If applicable, include DOH-354, Application for Certification, as the form may accompany that application.
- 4
Submit to the County
Submit the form to the county department named on it; check the county website for current contact details.
Frequently asked questions
- What is the On-Site Assessment of Water Treatment Plant and Distribution System Operator form?
- It documents an operator’s on-site assessment, including system knowledge, operational topics, laboratory skills, assessment results, and any recommendations.
- Who completes the water operator assessment form?
- The form records the operator’s information and assessment results, and includes fields for the assessor’s signature, title, and date.
- Do I need a notary for the water operator assessment form?
- No. This document is signed and dated without a notary, and it does not describe any attachment or related step that must be notarized or sworn.
- How do I submit the water operator assessment form?
- A completed form may accompany DOH-354, Application for Certification. Submit it to the county department named on the form; check the county website for current contact details.