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Contact Us
If you have questions concerning any of our programs, please call us at (304)530-6355.  We'll be glad to help you!

 

 


 

 

Animal Encounter

SG-58

Animal Encounter Report Online Form (Complete Form,  Print, and Deliver to us!)

 

Body Piercing/ Tattoo Studio

SG-49

General Sanitation Permit Application  (Complete Form, Print, and Deliver to us!)
SG-86 Piercing Studio Plan Review
SG-88 Piercing Technician Certification Application
SG-89  Information & Notification

SG-90

Hepatitis B Declination

64-80A

Body Piercing Studio Rule Public Notice

 

Child Care Centers

SG-49

 General Sanitation Permit Application  (Complete Form, Print, and Deliver to us!)

SG-99

 Plan Review Information for Child Care Centers (New or Remodeled)

 

Complaint

SG-51

Online Complaint Form (Complete Form,  Print, and Deliver to us!)

 

Food Sanitation

SF-4

Temporary Food Service Guidelines

SF-5

Food Establishment Permit Application
SF-7A Food Guide
SF -7B Equipment Guide
SF-7C Management Guide
SF-7D Employee Guide
SF-7E Inspection Guide
SF-35   Plan Review for New or Remodeled Food Establishments

1999 Food Code Plan Review References

Form 1-A

Applicant Food Employee Interview

Form 1-B

Food Employee Reporting Agreement
Form 1-C Applicant and Food Employee Medical Referral
OLS Request Food Filth Lab Analysis
PHSD Retail Food Emergency Flip Chart

 

General Sanitation

SG-49

 General Sanitation Permit Application  (Complete Form, Print, and Deliver to us!)

 

Mobile Home Park

SG-49

General Sanitation Permit Application  (Complete Form, Print, and Deliver to us!)
EG-1 Mobile Home Park Specification and Plan Review Summary Form
EG-2 Application for a permit to Construct, Install, Alter, or Extend a Mobile Home Park
EG-4 Sewage System Data Sheet

EG-5

Water System Designs

 

Recreational Water Facility

SG-49

General Sanitation Permit Application  (Complete Form, Print, and Deliver to us!)
ER-32 Recreational Water Facility Weekly Report

SR-153

Recreation Water Facilities Tables

 

Sewage

SS-182

Application for a Permit to Construct, Modify, or Abandon a Water Well and/or Install or Modify a Small Sewage Disposal System

SS-182A Application to Install or Modify a Small Sewage Disposal System
ES-57 Affidavit

 
     Home Aeration Unit (HAU) Forms:
HAU HAU Application Package
SS-188 Sewage System with Discharge Permit Application
SS-188A Surface Discharge Site Evaluation Report
SS-191 Annual Report For 600 GPD Point Source Discharge System
 
     Subdivision Forms:
ES-76 Subdivision Application
 
     Home Loan Evaluation Forms:
SG-55 Home Loan Evaluation Report
SG-55A Home Loan Evaluation Procedures
 
     Septic Tank Cleaner Forms:
SS-181 Application For Sewage Tank Cleaning Permit
 
     For Installers Only:
SS-192 Installer Certification Renewal Application

 

Water

SW-253 Water Analysis Request (Complete Form, Print, and Deliver to us!)
SW-253a Dug Wells (Prior to 2008)
SW-253b Approved Pitless Well Installation (Prior to 2008)
SW-253c Springs
SW-253d Cisterns
SW-253e Installing a Pump
SW-253f Approved Well House Installation (Prior to 2008)
SW-253g Pitless Units
SW-256 Water Well Application
SW-258 Water Well Completion Report
SW-260 Water Well Variance Request
SW-261 Water Well Abandonment Report
SW-262 Water Well Pump Installation Report
DW-22 Water Well Violation Report
2008 Water Quality Labs
  What to Do Before Drilling the Well
  Water Well Pumping System
  Four Steps to Water Well Safety
  How to Disinfect a Private Water Well

 

 

The forms are in  PDF format and require that your computer uses Adobe® Reader software.  Click on the icon above to download free software.


 

Please Note

If you experience difficulty in downloading or printing forms, please refer to the Adobe Web Site for troubleshooting and support guidelines.

Helpful Tip

The online forms will not save your information.  you must type in responses and print the document before closing.  Mail document to address on the contact page or walk in and deliver form to us.

 

         
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