Form 6a - Verification Of On The Job Experience
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12140 Hamilton Street
FORM 6A
Regina, Saskatchewan
Verification of
S4P 2E3
On The Job Experience
Tel (306) 787-2444
Toll Free 1-877-363-0536
Fax (306) 787-5105
PLEASE PRINT CLEARLY
Apprentice/Tradesperson
Social Insurance Number
Current Address
City
Postal Code
Phone Number
Employer (Firm Name)
Name and Certificate Number of Supervising Journeyperson
Address of Employer
City
Postal Code
Phone Number
Plumber
Trade Time
Exposure
Period of Employment
to
In Hours
(DD/MM/YY)
(DD/MM/YY)
Type of Work (please print)
Occupational Skills: safety, use and maintain tools and equipment, organize work, perform
routine trade activities
Piping Preparation and Assembly: prepare pipe, join tube, tubing, pipe and fittings
Drainage, Waste, Vents and Sewage Treatment Systems: installation of sewers, sewage
treatment systems and rough in for interior drainage, waste and vent systems
Water Service and Distribution: installation of water services, potable water distribution systems
and pressure systems
Fixtures, Appliances and Water Treatment Systems: installation of plumbing fixtures and
appliances and water treatment systems
Low Pressure Steam and Hydronic Heating and Cooling Systems: installation of low pressure
steam systems, hydronic heating and cooling piping systems, generating systems and equipment,
system controls and transfer units
Specialized Systems: installation of piping and equipment for specialized systems and process
piping systems
installation of piping and equipment for natural and liquefied petroleum gas (LPG)
systems
Maintenance and Repairs: Maintenance and troubleshooting of plumbing-related systems and
components
Total Hours
I Certify The Above Hours Are Accurate
Date (DD/MM/YY)
Apprentice/Tradesperson (signature)
I Certify The Above Hours Are Accurate
Date (DD/MM/YY)
Employer Representative (signature)
Employer Representative (print name clearly)
For Commission Use Only
________________
_________________________
______________
Time Assessed:
Approved By:
Date:
(DD/MM/YY)
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