Below are forms and/or applications for a variety of programs offered through the Ashtabula County Health Department. You may print off any of these forms for your convenience.
We do NOT accept credit cards or out-of-state checks.
Please make checks or money orders payable to the Ashtabula County Health Department. A return check fee will be charged from the Treasurer’s Office per ORC Section 321.48 for any returned checks.
Ashtabula County Health Department
12 West Jefferson St.
Jefferson, OH 44047
If you would like more detailed information on these programs please select the appropriate link in the Environmental Health section.
DISPOSAL OF CONSTRUCTION AND DEMOLITION DEBRIS (C&DD) RESULTING FROM DEMOLITION OF A STRUCTURE
FOOD SERVICE OPERATIONS
MOBILE FOOD SERVICE
SERV-SAFE CLASS INFORMATION
HAULERS / Septage & Water
2018 Septage Haulers Registration
Water Haulers Application 2018
HOUSEHOLD SEWAGE TREATMENT SYSTEMS
Private Water Systems
Water Sample Request Form
Real Estate Site Inspection Form