Onsite Wastewater Management Systems Regulation

Onsite Wastewater Management Systems Regulation Application

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Application for Certification of Installer

Installer Certification is issued in accordance with Section 9(1) and Schedule F of the Onsite Wastewater Management Systems Regulation 83/2003 and may be issued to a person who:

has successfully completed an installer's training course approved by the director,
provides a copy of the training course certificate and/or grade statement,
submits a completed application for Certification of Installer, and
pays a fee of $100.00 plus GST for a term of five years.

Please contact the OWMS Program directly if you are an Out-of-Province Installer by emailing OWMS@gov.mb.ca

Information Disclosure Consent

I consent to the publication of my name, certification status, and business contact information on the department's website for the purpose of public access to certified installers. I understand that my information will remain posted throughout the validity of my certification. I also understand that I may revoke or amend this consent in writing at any time by contacting the program at OWMS@gov.mb.ca.

Application Information

Is this application for renewal of a certificate? Yes No

Applicant Information

Applicant's Name:

Business Name:

If you are Self-Employed, you may enter your personal name.

Business Address:

Rural Municipality:

City:

Postal Code:

Business Phone Number:

Cell Phone Number:

Email:

Employer Information (If Applicable)

Employer's Name:

Address:

City:

Postal Code:

Phone Number:

Declaration

I hereby declare that the contents of this application are true and understand that providing false information may result in the refusal, cancellation or suspension of my Certification.

Submitted By:

Date:

Registration Fee plus 5% GST: GST Registration No. R107863847
Registration Fee (B-20-7) - $100.00 + $5.00 = $105.00

Note: It is your responsibility to apply for a renewal 60 days before the expiration of the registration and pay the renewal fee.

Personal information is collected under the authority of Section 9(2) and Schedule F of the Onsite Wastewater Management Systems Regulation of The Environment Act, and will be used to issue certificates and for administration and enforcement purposes. Personal information collected is protected by the privacy provisions of The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection and use of the information, contact the Onsite Wastewater Management Specialist, Box 36 - 14 Fultz Boulevard, Winnipeg MB R3Y 0L6 or at OWMS@gov.mb.ca