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New York State Department of Environmental Conservation
Division of Water, 625 Broadway, 4th Floor
Albany, New York 12233-3505
Trainee Form for 4-Hour ESC Training
*IMPORTANT:RETURN THIS FORM TO THE TRAINING SPONSOR
State Zip Code
-
Trainee Phone
- -
Trainee First Name
Trainee eMail 1
A Stormwater Trainee (SWT) identification (ID) number will be assigned to each person that
completes the NYSDEC 4-hour training in the principles and practices of erosion and
sediment control (ESC) to satisfy the State Pollution Discharge Elimination System (SPDES)
Construction Activity General Permit #GP-0-15-002. Each trainee that wishes to obtain a
wallet card with the SWT ID must provide the contact information requested below,
including his/her home mailing address. The trainee must be prepared to show his/her NYS
Driver License (or non-driver photo ID with proof of address) on the day of training to
verify that the information below is correct. NYSDEC recommends that this form be
completed as a PDF form on computer (or hand-written in blue or black ink) and sent to the
training sponsor by the pre-registration deadline (in advance of the training) either by
email or through the mail.
Trainee Last NameMI
Trainee Home Mailing Address 1st Line (same as NYS Driver License)
Trainee Home Mailing Address 2nd Line (if applicable)
City (same as NYS Driver License)
Trainee County of Residence
Trainee eMail 2 (optional)
Trainer First Name Trainer Last Name
MI
Sponsoring County SWCD Name
For DEC or Delegate Use Only
Trainer SWT No
Trainee Training Date
- -
Training Location Building/Street
Training Location City State Zip Code
-
Trainer Comments
3511475040
