The following forms may be downloaded, viewed and printed. Please be sure to follow the directions included on each form to assure that all required information is filled out before the form is submitted.

If you have trouble loading the forms, please email Michelle Jenkins at mjenkins@neiwpcc.org or call (978) 349-2516.

Form for trainers to fill out for Mass Title 5 System Inspector and/or Soil Evaluator training contact hour (TCH) approval:

There is no fee to submit a TCH approval request. To apply, please complete the form and include the following:

  • Course outline or agenda
  • List or samples of course materials
  • Speaker biographies

The review process typically takes about two weeks, as requests must be reviewed and voted on by the board.

You may submit your request either before or after the class is held—whichever works best for you. However, please do not advertise the hours as “approved” until you receive confirmation from us. You may list them as “pending approval” in the meantime.

Once your request packet is complete, please email it as one PDF to title5@neiwpcc.org.

Form for pre-approved candidates to become System Inspectors (not used for the class):

Massachusetts Registered Professional Engineers (civil, sanitary and environmental), Certified Health Officers, and Registered Sanitarians are not required to take the course and examination in order to become certified MA Title 5 System Inspectors, but must submit an application fee of $100 (payable to NEIWPCC) along with this (completed) form and proof of eligibility.

Form to change Active/Inactive status on Title 5 approvals:

In order to change from INACTIVE to ACTIVE status, the applicant must provide evidence of having obtained 10 training contact hours of approved training, within the current calendar year.

Please complete and submit this form to NEIWPCC at the address above in order to change the status of your Title 5 system inspector or soil evaluator approval. There is a $25 administrative fee (made payable to NEIWPCC) that must be submitted along with a completed status change form.

Form to get a reprint of wall certificate or wallet card:

Renewal forms for first time renewals only:

All other renewals (renewals with June 30th expiration date) are issued an individual invoice. These invoices are mailed out in March and again in May of the renewal year. If you need a copy, please email title5@neiwpcc.org and include your SE and/or SI certification number and another copy will be emailed to you.