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
440-576-6010
If you would like more detailed information on these programs please select the appropriate link in the Environmental Health section.
Animal Bites/Rabies
ANIMAL BITE FORM
DISPOSAL OF CONSTRUCTION AND DEMOLITION DEBRIS (C&DD) RESULTING FROM DEMOLITION OF A STRUCTURE
C&DD APPLICATION
FOOD SERVICE OPERATIONS
Application for FSO or RFE
TEMPORARY FOOD LICENSE APPLICATION
Vending Machine Application
MOBILE FOOD SERVICE
QUESTIONS & ANSWERS ABOUT MOBILES
APPLICATION FOR MOBILE FOOD LICENSE
SERV-SAFE CLASS INFORMATION
HAULERS / Septage & Water
2018 Septage Haulers Registration
Water Haulers Application 2018
HOUSEHOLD SEWAGE TREATMENT SYSTEMS
Home Sewage Treatment Service Provider Application
Application to Install Home Sewage Treatment System
Procedure for getting a Site Evaluation
Site Inspection Form
OK TO USE SITE INSPECTION
Real Estate Site Evaluation
VARIANCE REQUEST
Guidance Packet
Plumbing
Commercial Plumbing Plan Review
Plumbers Registration 2018
Private Water Systems
Chlorination_Procedure
Water Sample Form
Variance Request
Real Estate Site Evaluation
** OHIO DEPARTMENT OF NATURAL RESOURCES WATER WELL LOG***