Downloadable forms from the ADLM County Environmental Public Health Department.

These forms are from the county Environmental Health office and are for general public use. These files have been created for your use and are in a PDF format. If you don't have a program that can read PDF files, please click HERE to get the Adobe Reader. Other information may go here also as deemed needed by the Office Holder.

	FOOD
	Complaint Form
	Application for Temporary Food Service
	Temporary Food Service Pre-Opening Self-Inspection Checklist
	Application to Sell Potentially Hazardous Foods at a Farmer's Market
	Temporary Food Establishments and Farmer's Market Potentially Hazardous Food Licensees (.pdf document)
	Temporary Food Stand Hand Washing Setup (.pdf document)
	Application for Mobile Food Unit / Pushcart License
	Application for Retail Food Establishment License (Grocery)
	Application for Food Service Establishment License (Restaurant)
	Application for Home Food Establishment
	HOTEL / MOTEL
	Hotel / Motel Application
	Hotel / Motel Application Pg.2
	SEPTIC
	Application and Permit Decentralized Disposal System
	OSWAP Approval Form
	WELLS
	Application for Private Water Construction Permit
	Abandoned Water Well Plugging Record
	Requirements for Properly Plugging Abandoned Wells (.pdf document)
	ISUE: Safe Farm: Abandoned Wells Pose a Safety Hazard (.pdf document)
	ISUE: Coping With Contaminated Wells (.pdf document)
	Groundwater Hazard Statement Form / Groundwater Hazard Statement Instructions
	OTHER
	Application for a Warehouse License
	Vending Machine Application
	Vending Machine Application Pg.2