Downloadable forms from the ADLM County Environmental Public Health Department.


  Environmental Health Forms: Appanoose, Davis, Lucas & Monroe
                                                                      Counties (ADLM)

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

Adobe PDF icon Complaint Form
Adobe PDF icon Basic Requirements for a Food Establishment
Adobe PDF icon Food Establishment License Application
Adobe PDF icon Temporary Food Service Establishments and Farmer's Markets Operator's Guidelines
Adobe PDF icon Application for Temporary Food Service
Adobe PDF icon Application for Farmer's Market Food Establishment
   
  HOTEL / MOTEL
Adobe PDF icon Application for a Hotel License
Adobe PDF icon Application for a Hotel License - page 2
   
  SEPTIC
Adobe PDF icon Application and Permit Decentralized Disposal System
Adobe PDF icon OSWAP Approval Form
   
  WELLS
Adobe PDF icon Application for Private Water Construction Permit
Adobe PDF icon Abandoned Water Well Plugging Record
Adobe PDF icon Requirements for Properly Plugging Abandoned Wells (.pdf document)
Adobe PDF icon ISUE: Safe Farm: Abandoned Wells Pose a Safety Hazard (.pdf document)
Adobe PDF icon ISUE: Coping With Contaminated Wells (.pdf document)
Adobe PDF icon Groundwater Hazard Statement Form / Groundwater Hazard Statement Instructions
   
  OTHER
Adobe PDF icon Application to Operate a Vending Machine
Adobe PDF icon Application to Operate a Vending Machine - page 2

 
             

Playground at Grant Elementary School

Cannon - Lovilia, Iowa

Melrose Methodist Cemetery

Monroe County Courthouse - lawn