Operator of the Year Nomination Form INSTRUCTIONS: All fields must be completed for Award eligibility. Please refer to the "Operator of the Year" Awards Criteria as you complete this application. To be considered in the next Award, your completed form must be submitted by the extended deadline Wednesday, July 15th. GOOD LUCK! Operator DescriptionPlease refrain from using all caps/uppercase letters, please use sentence structure letter case.Operator Name*Plant/Employer*Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Telephone*Email Address* State PWS ID#*TCEQ Plant ID#*Membrane Daily Average Operating Flow, gpd (mgd)*Brief Treatment Process Overview of Current Plant* ProfessionalOperator's License No. and Classification*Length of Time with Present Employer*Length of Time in Present Position*Total Years of Professional Experience*Years of Experience as a Plant Operator*Years of Experience with Membranes*Years of Experience with Water Treatment Plants*Years of Experience in Water Industry*Describe Plant Operations Experience*Please Provide the Number of Education Contact Hours and List Courses Attended During the Past 24 Months:*SCMA Membership (years)* Operator Deserves This Award BecauseOperator Deserves This Award Because:*Describe How the Operator Exhibits a Job Effort that is Above and Beyond the Normal Requirement for His or Her Position.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or Describe How the Operator Demonstrates a Working Knowledge of Membrane Process and Willingness to Further their Knowledge on a Regular Basis.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or Describe How the Operator Represents His or Her Employer in Positive Manner in the Water or Wastewater Industry.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or List Any Awards or Honors the Operator has Received.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or Describe How the Operator Demonstrates Good Character, Independent Judgement, and Leadership.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or Describe if the Candidate is Active in the Community or Industry Organization Such as AWWA or SCMA.*Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.Upload Supporting Documents Drop files here or Plant ViolationsHas Your Plant Had Any Violations as Recorded by the Local Regulation body within the Last Year?*YesNoPlease Specify the Date of Violation, Description of Violation, and Actions Taken to Remedy It* Your Contact InformationYour Name*Title*TelephoneEmail Address* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Comments and CaptchaQuestions/CommentsCAPTCHAPlease refer to SCMA’s Privacy Policy if you have any questions regarding your preferences.