FORMS-NEWSLETTERS-INFO

Illinois Department of Plumbing Health Staff *NOTE: program is now called Plumbing & Water Quality Program* Information verified as of July 18, 2017
  • Justin DeWitt, Chief, General Engineering Section
  • Brian Cox, Plumbing & Water Quality Program Manager
  • Frank W. Shimkus, Plumbing Consultant, Plumbing & Water Quality Program
  • Rhonda K. Hawkins-Jackson, Administrative Assistant and Licensing staff supervisor, Plumbing & Water Quality Program
  • Tina Cordova, Licensing, Plumbing & Water Quality Program
  • Leighanne Gustin, Licensing, Plumbing & Water Quality Program
  • Matt Popov, Plumbing Inspector- Edwardsville Region
  • Ray Hall, Plumbing Inspector- Edwardsville Region
  • Brad Leuck, Plumbing Inspector- Marion Region
  • Wendell Stevens, Plumbing Inspector- Marion Region
  • Larry Luka, Plumbing Inspector-Champaign Region
  • Jeremiah Deakin, Plumbing Inspector-Champaign Region
  • Tony Fatigato, Plumbing Inspector- West Chicago Region
  • Pete Prehn, Plumbing Inspector- Rockford Region
State Board of Plumbing Examiners: Information verified as of July 18, 2017
  • Timothy Atkisson
  • James Brinkman
  • John DeFrates
  • Thad Ellet
  • Brian McGrath
  • Philip Roknich
  • Robert Schafer
Forms - Water, Sewage & Plumbing: PDF iconNon-Community Public Water System Construction Application PDF iconApplication for Licensed Water Well Contractor's Closed Loop Well Certification PDF iconApplication for Registration as a State Closed Loop Well Contractor PDF iconExamination Application for State Closed Loop Certification PDF iconApplication for Portable Sanitation Business License Form PDF iconApplication for Portable Sanitation Technician and Technician Trainee Certification Form PDF iconApprentice Plumber's License Application PDF iconApprentice Plumber's Application Under JAC PDF iconPlumber's License: Application for Examination PDF iconPlumber's License: Examination Retake Form PDF iconCertified Plumbing Inspector: Application for Examination PDF iconPlumbing Contractor: Application for Registration PDF iconIrrigation Contractor: Application for Registration PDF iconIrrigation Contractor: Notice of Cancellation of Employment Registered Irrigation Employee PDF iconIrrigation Employee: Application for Registration
Forms - Plumbing: PDF icon Apprentice Plumber's License Application PDF icon Apprentice Plumber's Application Under JAC PDF icon Apprentice Plumber: Notice of Cancellation of Employment/Supervision  PDF icon Plumber's License: Application for Examination PDF icon Plumber's License: Examination Retake Form PDF icon Plumber Application Child Support Certification PDF icon Certified Plumbing Inspector: Application for Examination PDF icon Plumber's License: Application for Reciprocity for the City of Chicago Licensees PDF icon Retired Plumber's License Application PDF icon Plumbing Contractors: Application for Registration PDF icon Plumbing Contractors: Corporation Surety Bond Form PDF icon Plumbing Contractors: Limited Liability Company Surety Bond Form PDF icon Plumbing Contractors: Partnership Surety Bond Form PDF icon Plumbing Contractors: Sole Proprietor Surety Bond Form PDF icon Plumbing Contractors: Affidavit of No Employees PDF icon Worker’s Compensation Opt-Out Form PDF icon Irrigation Contractors: Application for Registration PDF icon Irrigation Contractors: Application Child Support Certification PDF icon Irrigation Contractors: Application for Registration of Irrigation Employee PDF icon Irrigation Contractors: Test Certificate Lawn Sprinkler System PDF icon Irrigation Contractors: Notice of Cancellation of Employment Registered Irrigation Employee PDF icon Irrigation Contractors: Affidavit of No Employees PDF icon Irrigation Contractors: Corporation Surety Bond Form  PDF icon Irrigation Contractors: Limited Liability Company Surety Bond Form  PDF icon Irrigation Contractors: Partnership Surety Bond Form  PDF icon Irrigation Contractors: Sole Proprietor Surety Bond Form  PDF icon Continuing Education: Application for Registration File Continuing Education: Electronic Roster for Plumbers
Title Plumbing Code Advisory Council
Website http://www.idph.state.il.us/about/advboards01.htm
Name (Last, First) Ascending Term Expires Member Since Appointed By Position County Title
Cochran, Linocln 01/01/2005 1996 Governor Member, Professional Engineer Sangamon
D'Amico, John 01/01/2012 08/25/2011 Governor Member, Elected Official Cook
Deakin, Jeremiah Thomas 01/01/2015 05/03/2012 Governor Member, Consumer Public Champaign
Doolan, Dennis 01/01/2016 05/03/2012 Governor Member, Licensed Plumber Tazewell
Fuchs, Andrew 01/01/2017 01/11/2015 Governor Member, Licensed Plumber Cook
James, Doyle 01/01/2017 05/03/2012 Governor Member, Consumer Public Rock Island
Karner, Lynn 01/01/2017 01/11/2015 Governor Member, Labor Rep. Sangamon
Majerowicz, James 01/01/2017 05/03/2012 Governor Member, Labor Relations Cook
Menzel, David 01/01/2006 2003 Governor Member, Licensed Architect Sangamon
Potts, Beverly 01/01/2016 1996 Governor Member, Licensed Plumber Tazewell
Shah, Nirav Statute Chair, Ex-Officio None Director, Department of Public Health
Tienstra, Gerald 01/01/2016 2003 Governor Member, Licensed Plumber Cook