|
Staff Review |
View* |
Record ID# |
ID CARD NO: |
EXP DATE |
Photo |
Print ID Card |
Application Date |
*Application Status2 |
For Reciprocity Applicants Only
- State of Current License |
For Reciprocity Applicants Only - Current
State Certification/License No. |
For Reciprocity Applicants Only
- Expiration Date of Current
State Certification |
Badgetype |
Class Code |
First Name |
Last Name |
MI |
Address |
City |
State |
Zip Code |
Phone |
Date of Birth
(mm/dd/yy) |
Applicant's Training Information |
Third Party
Event
Passed |
Upload Third-Party Event Results |
Evidence of Personal or Company
Liability Insurance |
Sex |
Height
(feet) |
(inches) |
Email Address |
Business Name |
Address2 |
City2 |
State2 |
Zip Code2 |
Telephone Number |
FAX Number |
Sam
Consultant |
Abatement-Renovation |
DLCP
Certified? |
Upload evidence of DLCP
basic business license |
Your Position |
Description of Duties |
Supervisor Name |
Supervisor's Phone Number |
Supervisor's Email Address |
Check if you plan on using
X-Ray Fluorescence (XRF) |
X-Ray Fluorescence |
Yes/No |
Statement |
Notes |
Amount |
Check Number |
DC Inspector E-mail |
Individual
Affidavit |
Clean Hands Certificate |
High
School |
Institution |
High School's Name |
High School's Address |
High School's Phone Number |
From |
To |
Degree |
Institution's Name |
Institution's Address |
Institution's Phone Number |
Relevant Work Experience |
Tax ID |
Business Email |
Type of Business |
Specify Type |
Abatement2 |
Demolition |
Inspections |
Risk
Assessments |
Project
Designs |
Renovation/Remodeling |
Clearance
Testing |
Other |
Other Type |
Name and Title of Company Officials |
DC Certificate |
Company/Business
Affidavit |
Education Credentials |
1st Audit Type |
2nd Audit Date |
1st Audit Date |
1st Type of Enforcement |
1st Date of
Enforcement
Action |
2nd Date of
Enforcement
Action |
2nd Type of Enforcement |
Consent Form |
For Renewals - Upload Previous/Current
D.C. Certification ID Card |
Payments |
Add Payment |
Create Document |
EFP FA |
EFP Date |
Create Document(PB) |
Related
Record |
Related
Violation |
Violation Citation |
Violation - Nature of Infraction |
1st Audit Inspector |
1st NOV
Compliance
Date |
1st NOV Sent Inspector |
2nd Audit Inspector |
2nd Audit Type |
2nd NOV
Compliance
Date |
2nd NOV Sent Inspector |
3rd Audit Date |
3rd Audit Inspector |
3rd Audit Type |
3rd Date of
Enforcement
Action |
3rd NOV
Compliance
Date |
3rd NOV Sent Inspector |
3rd Type of Enforcement |
4th Audit Date |
4th Audit Inspector |
4th Audit Type |
4th NOV
Compliance
Date |
4th NOV Sent Inspector |
4th Type of Enforcement |
5th Audit Date |
5th Audit Inspector |
5th Audit Type |
5th NOV
Compliance
Date |
5th NOV Sent Inspector |
5th Types of Enforcement |
6th NOV
Compliance
Date |
6th NOV Sent Inspector |
6th Types of Enforcement |
Additional
Fees |
Base Price |
Business Entity Applicants
- Review of Certification
Requirements |
Can DOEE post your contact information? |
Certification Card Number |
Child-Occupied
Facility |
Commercial |
Complete App Processed
within 5 days |
Compliance Assistance/Enforcement
after 1st Audit |
Compliance Assistance/Enforcement
after 2nd Audit |
Compliance Assistance/Enforcement
after 3rd Audit |
Compliance Assistance/Enforcement
after 4th Audit |
Compliance Assistance/Enforcement
after 5th Audit |
Compliance Assitance/Enforcement
after 4th Audit |
Copy of NOV Number |
Date 2nd
NOI Sent |
Date 2nd
NOV Sent |
Date 5th
NOV Sent |
Date 6th
NOV Sent |
Date Application
Was Deemed
Complete |
Date Audit
Assigned |
Date Created |
date for exact
form |
Date Fourth
NOV Sent |
Date Modified |
Date NOI Sent |
Date NOV Sent |
Date Second
Nov Sent |
Date Third
NOV Sent |
DHCD Lead-Safe Washington
Project for 1st NOV Sent |
DHCD Lead-Safe Washington
Project for 2nd NOV Sent |
DHCD Lead-Safe Washington
Project for 3rd NOV Sent |
DHCD Lead-Safe Washington
Project for 4th NOV Sent |
DHCD Lead-Safe Washington
Project for 5th NOV Sent |
DHCD Lead-Safe Washington
Project for 6th NOV Sent |
exp date
is null |
Extension |
Hand |
I am applying for a replacement
badge (only check box if your
request is not a renewal) |
Sam
DATE_PROCESSED |
I have a Non-DOEE accredited
training provider course |
I have a Non-DOEE accredited
training provider
course certificate |
Write Here What You Consent To Post On Our Website |
Item Received |
For Renewal Applicants Only - Expiring
or Expired D.C. Certification No. |
For Renewal Applicants Only - Expiring
or Expired D.C. Certification
Expiration Date |
Sam Has the processed certification been issued? |
ID Card Replacement
Fee Amount |
ID Card Replacement Fee
Check or Money Order # |
Individual Applicants -
Review of Certification
Requirements |
I am applying
for
Reciprocity |
Last Modified By |
Latest
Record? |
NOV Number |
NOV Number1 |
NOV Number2 |
NOV Number3 |
NOV Number4 |
PayPal
Invoice
Amount |
PayPal
Invoice
Paid |
Permit Issued
Date |
Permit Number |
Project Address |
Record Owner |
Residential |
Static
Value |
Static Value
- Maximum
Record ID# |
Record Status |
Violation |
Violation Citation 2 |
Violation Citation 3 |
Violation Citation 4 |
Website Address |
Would you like to pay by credit card? |
page - Date Created |
Documents |
Add Document |
xBusiness Name |
Tickets |
Add Help Ticket |
#1 |
#2 |
#3 |
#4 |
#5 |
#6 |
#7 |
#8 |
#9 |
#10 |
#11 |
#12 |
#13 |
#14 |
#15 |
#16 |
#17 |
#18 |
#19 |
#20 |
#21 |
#22 |
#23 |
#24 |
#25 |
#26 |
#27 |
#28 |
#29 |
#30 |
#31 |
#32 |
#33 |
#34 |
#35 |
#36 |
#37 |
#38 |
#39 |
#40 |
#41 |
#42 |
#43 |
#44 |
#45 |
#46 |
#47 |
#48 |
#49 |
#50 |
#51 |
#52 |
#53 |
#54 |
#55 |
#56 |
#57 |
#58 |
#59 |
#60 |
#61 |
#62 |
#63 |
#64 |
#65 |
#66 |
#67 |
#68 |
#69 |
#70 |
#71 |
#72 |
#73 |
#74 |
#75 |
#76 |
#77 |
#78 |
#79 |
#80 |
#81 |
#82 |
#83 |
#84 |
#85 |
#86 |
#87 |
#88 |
#89 |
#90 |
#1 Remark |
#2 Remark |
#3 Remark |
#4 Remark |
#5 Remark |
#6 Remark |
#7 Remark |
#8 Remark |
#9 Remark |
#10 Remark |
#11 Remark |
#12 Remark |
#13 Remark |
#14 Remark |
#15 Remark |
#16 Remark |
#17 Remark |
#18 Remark |
#19 Remark |
#20 Remark |
#21 Remark |
#22 Remark |
#23 Remark |
#24 Remark |
#25 Remark |
#26 Remark |
#27 Remark |
#28 Remark |
#29 Remark |
#30 Remark |
#31 Remark |
#32 Remark |
#33 Remark |
#34 Remark |
#35 Remark |
#36 Remark |
#37 Remark |
#38 Remark |
#39 Remark |
#40 Remark |
#41 Remark |
#42 Remark |
#43 Remark |
#44 Remark |
#45 Remark |
#46 Remark |
#47 Remark |
#48 Remark |
#49 Remark |
#50 Remark |
#51 Remark |
#52 Remark |
#53 Remark |
#54 Remark |
#55 Remark |
#56 Remark |
#57 Remark |
#58 Remark |
#59 Remark |
#60 Remark |
#61 Remark |
#62 Remark |
#63 Remark |
#64 Remark |
#65 Remark |
#66 Remark |
#67 Remark |
#68 Remark |
#69 Remark |
#70 Remark |
#71 Remark |
#72 Remark |
#73 Remark |
#74 Remark |
#75 Remark |
#76 Remark |
#77 Remark |
#78 Remark |
#79 Remark |
#80 Remark |
#81 Remark |
#82 Remark |
#83 Remark |
#84 Remark |
#85 Remark |
#86 Remark |
#87 Remark |
#88 Remark |
#89 Remark |
#90 Remark |
#91 |
#91
Remark-x |
#93 Remark |
#91 Remarks |
Combination
of Both |
Pop-up (old docs) |
Ready to
save
docs |
Edit (previous docs) |
Badge Credential |
sb4 |
Logs |
Add Log |
#1 Missing |
#2 Missing |
#3 Missing |
#4 Missing |
#5 Missing |
#6 Missing |
#7 Missing |
#8 Missing |
#9 Missing |
#10 Missing |
#11 Missing |
#12 Missing |
#13 Missing |
#14 Missing |
#15 Missing |
#16 Missing |
#17 Missing |
#18 Missing |
#19 Missing |
#20 Missing |
#21 Missing |
#22 Missing |
#23 Missing |
#24 Missing |
#25 Missing |
#26 Missing |
#27 Missing |
#28 Missing |
#29 Missing |
#30 Missing |
#31 Missing |
#32 Missing |
#33 Missing |
#34 Missing |
#35 Missing |
#36 Missing |
#37 Missing |
#38 Missing |
#39 Missing |
#40 Missing |
#41 Missing |
#42 Missing |
#43 Missing |
#44 Missing |
#45 Missing |
#46 Missing |
#47 Missing |
#48 Missing |
#49 Missing |
#50 Missing |
#51 Missing |
#52 Missing |
#53 Missing |
#54 Missing |
#55 Missing |
#56 Missing |
#57 Missing |
#58 Missing |
#59 Missing |
#60 Missing |
#61 Missing |
#62 Missing |
#63 Missing |
#64 Missing |
#65 Missing |
#66 Missing |
#67 Missing |
#68 Missing |
#69 Missing |
#70 Missing |
#71 Missing |
#72 Missing |
#73 Missing |
#74 Missing |
#75 Missing |
#76 Missing |
#77 Missing |
#78 Missing |
#79 Missing |
#80 Missing |
#81 Missing |
#82 Missing |
#83 Missing |
#84 Missing |
#85 Missing |
#86 Missing |
#87 Missing |
#88 Missing |
#89 Missing |
Search (read only) |
Individual - User Name (account) |
old-For Reciprocity Applicants Only
- State of Current License |
old-For Reciprocity Applicants
Only - Current State
Certification/License No. |
Available Business |
mx-Email Placeholder |
Email Address (old) |
Related
Business
(old) |
Select account holder |
Account ID# |