Request for Mentoring

Employer:

Position:

Years of Experience:

Mailing Address:

City:
State: Colorado  & Zip Code:

Telephone:

Fax:

Cell:

Email Address:

Availability: (check all that apply):

• Telephone
  
• Email
  
• Fax
  
• In Person
  
• Able to visit mentor's facility: Yes    No

Area(s) of Need: (check all that apply)

Regulations:

• Water Quality Standards
• Permitting Process
• Site Approval Process
• Pretreatment
• WLA/Analysis/TMDL
• Reuse
• Source Water Protection
• SDWA Regulations
• Other

• Primary/Secondary
• Sedimentation
• Advanced treatment
• Biosolids
• Reuse
• Filtration
• Disinfection
• Other

• Electrical/Mechanical
• Collection or Distribution Systems
• Pipelines/Transmission Lines
• Lift Stations
• Sampling
• Taste & Odor Control
• Residualas Handlings, Dewater & Disposal
• Iron & Manganese Control
• Other

• Asset & Organizational Management
• Database/Data Management
• Computer Services
• Compliance Monitoring & Reporting
• Record Keeping
• Public Information and Outreach
• Operator Certification
• Finance
• Other

• Procedures
• Whole Effluent Toxicity
• Organic/Inorganic
• Other

• System Security
• Data Security
• Record Keeping
• Surveillance
• Personal Protective Equipment
• Other

Is your employer aware of your interest in being mentored? Yes    No

Is your employer supporting your interest? Yes    No

Is this a confidential request? Yes    No

Comments: