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 extended deadline Monday, July 15, 2019. GOOD LUCK!

Operator Description
Please 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 Country
Telephone*
Email Address*
State PWS ID#*
TCEQ Plant ID#*
Membrane Daily Average Operating Flow, gpd (mgd)*
Brief Treatment Process Overview of Current Plant*
Professional
Operator'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 Because
Operator 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.*
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Describe How the Operator Demonstrates a Working Knowledge of Membrane Process and Willingness to Further their Knowledge on a Regular Basis.*
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Describe How the Operator Represents His or Her Employer in Positive Manner in the Water or Wastewater Industry.*
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List Any Awards or Honors the Operator has Received.*
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Describe How the Operator Demonstrates Good Character, Independent Judgement, and Leadership.*
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Describe if the Candidate is Active in the Community or Industry Organization Such as AWWA or SCMA.*
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Plant Violations
Has Your Plant Had Any Violations as Recorded by the Local Regulation body within the Last Year?*
- Yes
- No
Please Specify the Date of Violation, Description of Violation, and Actions Taken to Remedy It*
Your Contact Information
Your Name*
Title*
Telephone
Email Address*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
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Operator Description

Professional

Operator Deserves This Award Because

Plant Violations

Your Contact Information