Application/Permit  and Site Plan Form: Required Prior to Constructing, Altering, or Sealing Private Water Systems:

Application/Permit for Private Water Systems (electronic fill in)

Additional Plans required under OAC 3701-28-03 (E) and (F) for ponds, cisterns, springs, buildings, and more than three family residences:

Additional Site Plans

Administrative Summary (For Health Department use only)

Administrative Summary for Private Water System Permit for Health Department Use Only (electronic fill in)

 Job Status / Completion Forms: Submitted to the Local Health Department after work on the Private Water System has been completed.

Job Status/Completion Form For Private Water Wells (electronic fill in)

Job Status/Completion Form for Cisterns and Hauled Water Storage Tanks

Job Status/Completion Form for Private Water System Ponds

Job Status/Completion Form for Private Water System Springs

Job Status/ Completion Forms for Continuous Disinfection

  Last updated 3/31/11