Application Process: Application Forms

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With the 2008 revisions to Chapter NR 149, the application form has subsequently been split into three key parts: the main application, the Federal Employer Identification Number (FEIN) form [for initial and transfer-of-ownership applications], and one or more attachments indicating the combinations of Matrix-Technology-Analyte (Matrix-Method-Analyte for drinking water) for which certification or registration is being requested.

Main Application Form

Download a copy of Form 4800-02, the main application form. All labs must complete this form, whether applying for initial, revised, reciprocity, or transfer-of-ownership.

Federal Employer Identification Number (FEIN) Form

Download a copy of Form 9400-568, the Social Security Number/ FEIN Request Form. All labs applying for either initial certification/registration or reporting a Transfer-of-Ownership application must also complete and submit this form. State law requires this information. Read the form instructions for further information.

Attachments: Selection of Matrix-Technology-Analyte or Matrix-Method-Analyte

Labs submitting either initial or revised application must also include one or more of the following attachments which are used to identify the specific combinations of Matrix-Technology-Analyte or Matrix-Method-Analyte for which certification or registration is desired.

• Download a copy of Attachment B to Form 4800-02, which is designed for small industrial & wastewater labs performing testing limited to BOD, ammonia, TSS, total phosphorus, chloride, residual chlorine, pH, and DO.



• Download a copy of Attachment A1 to Form 4800-02, which contains the complete list of Technology-Analyte combinations for the AQUEOUS matrix.



• Download a copy of Attachment A2 to Form 4800-02, which contains the complete list of Technology-Analyte combinations for the SOLID matrix.



• Download a copy of Attachment A3 to Form 4800-02, which contains the complete list of Method-Analyte combinations for the DRINKING WATER matrix.