Public Health – Forms

General Forms:

Animal Bites and Rabies Risk Part I
Animal Bites and Rabies Risk Part II
Rabies Program – Human Exposure Report
2013 Environmental Health Penalties/Fines for Violations

Food Service Forms:

Cover Letter
Food Service Fee Schedule
State Department of Health Application for a Permit to Operate
Application for Approval of Plans
What Size Greasetrap Do I Need?

Water System Forms and Information:

Application for Approval of Plans for Public Water Supply Improvement
Standards for Water Wells
Special Requirements for Wells Serving Public Water Systems
INDIVIDUAL WATER SUPPLY WELLS – FACT SHEET #1
INDIVIDUAL WATER SUPPLY WELLS – FACT SHEET #2
INDIVIDUAL WATER SUPPLY WELLS – FACT SHEET #3
INDIVIDUAL WATER SUPPLY WELLS – FACT SHEET #4
Maximum Contaminant Levels (MCL)
Maximum Contaminant Levels (MCL) 2
Regional Testing Labs

Permit to Operate Forms:

Application for Permit to Operate
Fee Schedule
Mobile Home Park Fee Schedule
Workers Comp/Disability Instructions

Children’s Camp Forms:

Aquatic Certifications
Camp Director Certified Statement
Children’s Camp Checklist
Children’s Camp Staff Qualifications
CPR Certification
First Aid Certification
Statewide Central Register Database Check Form
Level III & IV CRP Certification
Level III Aquatic Staff Certification
Swimming Pool Operator Certification
Swimming Pool Safety Plan
Swimming Pool Plan Review Checksheet

Sewage & Septic Forms:

Instructions
Education Law Requirement
Application
Additional Perc Test Directions
Perc Test Reporting
Engineer List
Contractor List
Commercial Sewage Application