Transcription of Boiler engineer license exam application
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Boiler engineer license exam application
I ndividual Boiler Engin eer Li cense Examination application application Fee = $ IN BOX FOR OFFICE USE ONLY SELECT THE license YOU ARE APPLYING FOR: Chief A Class 1A C las s 2 A C las s Chief B Class 1B C las s 2 B C las s Chief C Class 1 C Class 2 C Class Spec ial E ngi neer H istorical Boiler E ngi neerAccount Number 632448 STK B42 BOILLIC Check Number Amount Paid PCK CCK MODLI Deposit Date NOTICE: Pursuant to M innesota Statute , checks returned for non payment will be charged a $30 service charge and may s ubject the issuer to additional civil pe nalti this a license exam retest? YES NO If YES, submit application form and fee. Affidavit form is not required. PRINT IN INK OR TYPEMAKE A COPY OF THIS application FOR YOUR RECORDS application NUMBER: license NUMBER: Boiler license NUMBER In the space below, enter Minnesota Boiler engineer lic ense number(s) currently held, if ap plicable.
Must complete total operating experience in one of the following categories: Steam Boiler Plant, Hot Water Boiler Plant; Steam Engines/Steam Turbines or High Pressure Hours. Note: Make sure total hours are recorded. Required total amount of time shown with specific dates of employment indicated.
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