Environmental Health Services Forms 
                             and Publications...bs01064_.wmf (8916 bytes)
 

     The below links will take you directly to the Program selected.........
     General Use        Food Program    Recreational Health   Liquid Waste    WATER PROGRAM
    BODY ADORNMENT  PESTICIDE REPORT

Each form name has a link to a form. Some forms are available in Microsoft Word documents (.doc) and other may be in Adobe Portable  Document Format (.pdf).  In order to view the forms properly, you may have to download a Microsoft Word viewer or an Adobe Acrobat Reader, which are provided below.

Adobe Acrobat Reader

 

                 Microsoft Word Viewer

                     General Use                         

Environmental Health Service's Fee Schedule         Public Record Review Agreement 
Known or Suspected Pesticide-Related Illness 

                          Food Program                                   

        Calif. Retail Food Code (CalCode)               
        Opening a Restaurant Guide                           Health Permit Application
        Food Vendor Schedule of Stops                       Food Plan Check Form   
        Statement of Commissary Use (English)          Statement of Commissary Use (Spanish)
        Veteran's fee exemption for Health Permit  
        Calif. Health and Safety Code Revisions Affecting Mobile Food Facilities (MFF)
                           Form (English)         Forms (Spanish)                

    Temporary Food Facility Forms
         Temporary Food Facility Guidelines   Request for Exemption - Food Facility

       Event Organizer Packet: (forms #1, #2 and #3 MUST be completed)
       #1 Event Organizer Application    #2 Sketch Sheet 2- Event diagram  
       #3 Name of Booths/Organization  

       Temporary Food Booth Packet: (forms #1, #2, #3. #4 and #5 MUST be completed)
        #1 Temporary Food Booth Application   #2 Sketch Sheet 1 - Booth diagram
       #3 Employee log     #4 On-site Food Preparation at temporary booth   
       #5 Off-site Food Preparation at a licensed permanent food facility  
        

            Recreational Health Program              

  Pool / Spa Application Form
Pool Plan Check Form

   
 

                   Liquid Waste Program                                 

Homeowners' Septic System Guide  
Onsite Sewage Treatment System Permit Application:
New Sewage Treatment System
Graywater System
Repair
Modification
Abandonment
Application Instructions: Onsite Sewage Treatment System: New System
Application Instructions: Onsite Sewage Treatment Repair/Modification
Application Instructions: Onsite Sewage Disposal System Abandonment
Application And Instructions: Onsite Sewage Treatment: Evaluation
Onsite Sewage Disposal System Minimum Horizontal Distance In Clear - Table I-1 and
Capacity of Septic Tanks - Table I-2
State Regional Water Quality Control Board Prohibitions
Septic System Sanitary Survey Report (PDF Format)  
Septic System Sanitary Survey Appendix  

                   Water Program                                 

Well Permit Application  

Single Parcel Water System Permit Application (1-4 connections)
Instructions - Single Parcel Water System Permit Application
Single Parcel Water System Application Plot Plan (Enclosure #1)
Schematic Diagram For A Typical Single Parcel Water System (Enclosure #2)
Single Parcel Water System Exclusive Ownership Declaration (Enclosure #3)
Water Treatment Letter (Enclosure #4)

 
 
 
 
 
 

Body Adornment
Body Adornment Application form Body Adornment Application
Pesticide Illness
Known or Suspected Pesticide-Related Illness  

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