Please complete the survey below. You must do at one time, it can not be saved for you to complete later, Press submit when completed. Thank you for your participation and continued support. Please enable JavaScript in your browser to complete this form.Utility Name *Email Address *Utility Type *Water and/or SewerSanitation DistrictWater AssociationMunicipalityPrivateWater Commission# Service Water Connection Only type numbers# Service Wastewater Connection Only type numbersTotal # Employees (Water)Only type numbersTotal # Employees (Wastewater)Only type numbersHealth Insurance? *YesNoHealth Insurance Employer Paid? *YesNoHealth Insurance % Employer Paid SingleHealth Insurance % Employer Paid FamilyLife Insurance? *YesNoRetirement *YesNoSocial Security OnlyRetirement % Employee ContributionRetirment % Employer ContributionVacation Leave *YesNoSick Leave *YesNoIncentive/Merit Pay *YesNoDescribe Incentive PayOther Benefits Position(s) Information Title (only select one, you can add additional employees below) *ManagerAsst. ManagerSuperintendentAsst. SuperintendentFinance Director/AccountantEngineerOffice ManagerAsst. Office ManagerCity ClerkAsst. City ClerkBookkeeperCustomer Service RepresentativeWater Plant Superintendent/ForemanWastewater Plant Superintendent/ForemanDistribution Supervisor/ForemanMaintenance Supervisor/ForemanMeter Reading ForemanWater Plant OperatorWater Distribution OperatorWastewater Plant OperatorWastewater Collection OperatorEquipment OperatorMechanic/ElectricianMeter ReaderLaborerEmploymentFull TimePart TimeYears of ServiceOnly Type NumbersYears in Current PositionOnly type numbersAnnual Salary/Hourly RateOnly Type numbersIs Certification RequiredYesNoCertified by the State (LDH)YesNoTypes of Water CertificationsWater Production Level 1Water Distribution Level 1Water Treatment Level 1Water Production Level 2Water Distribution Level 2Water Treatment Level 2Water Production Level 3Water Distribution Level 3Water Treatment Level 3Water Production Level 4Water Distribution Level 4Water Treatment Level 4Number of Years in Current Water CertificationTypes of Wastewater CertificationsWastewater Collection Level 1Wastewater Treatment Level 1Wastewater Collection Level 2Wastewater Treatment Level 2Wastewater Collection Level 3Wastewater Treatment Level 3Wastewater Collection Level 4Wastewater Treatment Level 4Number of Years in Current Wastewater Certification Click here to add additional employees Other (use this section if title is not listed in choices) TitleEmploymentFull TimePart TimeYears of ServiceOnly Type NumbersYears in Current PositionOnly type numbersAnnual Salary/Hourly RateOnly Type numbersIs Certification RequiredYesNoCertified by the State (LDH)YesNoTypes of Water CertificationsWater Production Level 1Water Distribution Level 1Water Treatment Level 1Water Production Level 2Water Distribution Level 2Water Treatment Level 2Water Production Level 3Water Distribution Level 3Water Treatment Level 3Water Production Level 4Water Distribution Level 4Water Treatment Level 4Number of Years in Current Water CertificationTypes of Wastewater CertificationsWastewater Collection Level 1Wastewater Treatment Level 1Wastewater Collection Level 2Wastewater Treatment Level 2Wastewater Collection Level 3Wastewater Treatment Level 3Wastewater Collection Level 4Wastewater Treatment Level 4Number of Years in Current Wastewater Certification Click here to add additional employees Submit