Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 179 - PUBLIC WATER SYSTEMS
Chapter 10 - LICENSURE OF WATER OPERATORS
Attachment 179-10-1 - APPLICATION TO SERVE AS A LICENSED OPERATOR FOR MORE THAN ONE NEBRASKA PUBLIC WATER SYSTEM

Current through September 17, 2024

The operator or water system taking on responsibilities for more than one water system is required to notify the Department by sending this form to the DHHS, Division of Public Health, P.O. Box 95026, Lincoln, NE 68509-5026. When the agreement terminates, the operator or water system is also required to notify the Department.

System 1 is the system with a current licensed operator.

System 2 is the system requesting to share the licensed operator of System 1.

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