The Office of Indiana State Chemist is temporarily located in AGAD (615 W. State Street, Room 18, West Lafayette, IN 47907).
Visitor paid parking is available in the Harrison Street Garage. Our mailing address remains the same (175 S. University Street, West Lafayette, IN 47907-2063).
Request for Continuing Certification Hour (CCH)
Approval Worksheet Submission Form
Instructions for Completing the CCH Approval Worksheet
a) Enter the title of your program as it will be advertised to the public.
b) List site location - street address, city, state, zip code.
c) Include definitions of any acronyms used in your presentation descriptions.
All programs approved for CCHs must be open to the public. These programs, including the program sponsor contact's name and phone number will be posted to the Office of Indiana State Chemist (OISC) website when approved.
Enter the dates for the conference/program. Enter the link to your on-line registration form to this program if available.
a) Use additional worksheets, as needed, for multiple days. If submitting additional worksheets via e-mail, please indicate how many pages you will be sending.
b) Do not list on this worksheet any presentations that you believe do not have any pesticide or fertilizer applicator/technician competency content in them. Subject matter and content must include, but may not be limited to, at least one (1) of the following:
PESTICIDES:
Pest identification
Pest biology
Pesticide chemistry
Pesticide equipment calibration and maintenance
Pesticide use
Pest management by cultural, mechanical or other non-pesticide means, including, but not limited to the following:
Sanitation;
Exclusion;
Fertilization;
Irrigation;
Soil compaction; and
Pest monitoring
Pesticide label interpretation
Pesticide label safety measures
Public and customer safety
Consumer and customer complaints
Applicator safety
Environmental safety
Associated state and federal laws or regulations affecting pesticides or pesticide users
FERTILIZERS:
Fertilizer material storage
Fertilizer material chemistry
Fertilizer material equipment calibration and maintenance
Fertilizer material use
Fertilizer material transportation
Fertilizer material application development and implementation
Spill response procedures
Public and customer safety
Public and customer concerns
Applicator safety
Environmental safety
Environmental issues
Employee training
Associated state and federal laws or regulations affecting fertilizer applicators
c) Subject matter and content may not include any of the following:
Product or service sales or promotions
Employee hiring or retention
General business practices
d) List for each presentation all of the categories for which you feel the presentation material is appropriate. The categories you list should be based on specific presentation content and your anticipated target audience. The category descriptions are as follows:
1 - Agricultural Pest Management
2 - Forest Pest Management
3a - Ornamental Pest Management
3b - Turf Management
4 - Seed Treatment
5 - Aquatic Pest Management
6 - Industrial Weed Management
7a - Industrial, Institutional, Structural & Health-Related Pest Management
7b - Termite Control
7d - Fumigation
8 - Mosquito Management (Community-Wide)
11 - Aerial Application
12 - Wood Destroying Pest Inspection
14 - Agricultural Fertilizer Application
a) Completed CCH approval worksheet requests must be submitted to OISC at least three (3) weeks in advance of the program date. If you suspect that there may be a problem with timely submission of the request, contact Leo Reed at (765) 494-1588 for guidance.
b) Completed worksheets may be mailed, faxed or e-mailed to:
Cassie Davis
Office of Indiana State Chemist
175 S. University Street
West Lafayette, IN 47907-2063
Telephone: 765-494-9563
Fax: 765-494-4331
E-mail: davi1090@purdue.edu
c) CCHs will be awarded as whole numbers for each applicable category on a per-day basis. One (1) CCH will be awarded for one (1) hour of appropriate presentation time. Questions or discrepancies about the number of CCHs awarded should be directed immediately upon your notification of approval/denial from OISC. Inquiries should be directed to Leo Reed at (765) 494-1588 or by e-mail: reedla@purdue.edu