Washington Certification Services

Washington Certification Services

Water Works Operators

Waterworks Operator Change of lnformation Form

Certified waterworks operators must submit this form to notify Department of Health and Washington Certification Services of changes to their contact information. Only a home address will be accepted as the mailing address of record. The Waterworks Operator Certification Program will not consider an appeal from an operator that is assessed a renewal late fee, does not renew a certificate, or does not meet the professional growth requirement due to failure to provide a valid home and email address.

Required Verification Information

I certify that I am the operator identified above and I authorize Department of Health and Washington Certification Services to make these changes to my contact information. I understand that third parties, such as employers, are prohibited from submitting changes.

Change Operator Information

Enter only the information that has changed.

Name Change

Change Employer Information