Application for Onsite Certificate Renewal Fact Sheet
This guidance document is advisory in nature but is binding on an agency until amended by such agency. A guidance document does not include internal procedural documents that only affect the internal operations of the agency and does not impose additional requirements or penalties on regulated parties or include confidential information or rules and regulations made in accordance with the Administrative Procedure Act. If you believe that this guidance document imposes additional requirements or penalties on regulated parties, you may request a review of the document.

Form #:  12-055
Guidance Documents
Revised: 11/28/16


All certificates by examination in any category expire December 31 of every odd-numbered year unless renewed in accordance with Title 124 - Rules and Regulations for the Design, Operation, and Maintenance of Onsite Wastewater Treatment Systems. To renew a valid certificate, the certified professional must submit the following required information to the Department or on forms provided by the Director. All information shall be typed or legibly printed:
  • A request that includes
    • The words “Application for Onsite Certificate Renewal”;
    • The applicant’s full name (first name, middle initial, and last name), mailing address and phone number;
    • A listing of each certificate category the applicant wishes to renew ;
    • The statement “I swear or affirm that the information and documentation submitted are true, complete, and accurate”; and
    • The applicant’s signature and date signed.
  • A Record of Continuing Education including:
    • The certified professional’s full name (first name, middle initial, and last name), mailing address, phone number and certification number;
    • For each educational program or course attended/completed:
      • The date of the program;
      • A description of the educational program;
      • The name of the provider of the program;
      • The program location; and
      • The number of Department approved professional development hours (recorded to the nearest quarter hour) obtained by the certified professional for participation in that program recorded to the nearest quarter-hour.
    • The statement “I swear or affirm that the information and documentation submitted are true, complete, and accurate”; and
    • The certified professional’s signature and date signed.
  • The certificate renewal fee

If the Department does not receive the application for renewal, which includes the renewal fee, and record of continuing education, prior to the expiration date of the certificate, the certificate will expire. However, a person may late renew their expired certificate within 60 days after the certificate has expired by submitting to the Department a completed application for onsite certificate renewal, record of continuing education, the certificate renewal fee and a $50 late renewal penalty. The late renewal application, record of continuing education, certificate renewal fee and late penalty must be received by the Department no later than 60 days after the certificate has expired. Once the 60 day late renewal period has expired, in order to obtain certification the individual shall submit an application for examination including the application fee along with the examination fee for each category, and pass the examination in for each category desired.

The certificate of any certified professional who fails to comply with the continuing education requirements of Title 124 will expire on the expiration date of the certificate.