LIC 9275 - External Water Sampler Self-Certification Form

The LIC 9275 form is an External Water Sampler Self-Certification Form used by water sampling professionals or entities responsible for collecting water samples for facilities regulated by the California Department of Social Services. This form verifies that the external water sampler meets the required qualifications, certifications, and training to ensure accurate and reliable water sample collection. It may include details such as the sampler's name, contact information, certifications held, sampling methods employed, and compliance with applicable regulations. By completing this self-certification form, external water samplers affirm their competence and compliance with industry standards.