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
Application for Temporary Food Service
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
Application to Install Home Sewage Treatment System
SITE INSPECTION FORM
OK to Use Site Inspection Form
Real Estate Site Inspection Form
VARIANCE REQUEST
PROCEDURE FOR GETTING A SITE EVALUATION
Guidance Packet
Plumbing
Commercial Plumbing Plan Review
Plumbers Registration 2018
Private Water Systems
Chlorination_Procedure
Water Sample Request Form
Variance Request
Real Estate Site Inspection Form
OHIO DEPARTMENT OF NATURAL RESOURCES WATER WELL LOG SEARCH