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Environmental Public Health Services  Permitting Forms

About Publication Forms

The forms below are used in our office.   They are listed by category. If you don't see the form you need call (561) 837-5900. 

The following documents are available for downloading in pdf (requires Adobe Acrobat Reader Software). There are also some PowerPoint files.

  • Download a free copy of Adobe Acrobat Reader software

Note: links for all pdfs open in a new window

 

Drinking Water

  • dep_62.555.900-1.pdf
    Application for:
    - Public Drinking Water Facility Construction Permit
     
  • dep_62.555.900-7.pdf
    Application for:
    - Notification for Use of General Permit for Constructions of an   Extension to a Public Drinking Water Distribution System
     
  • dep_62.555.900-9.pdf
    Application for:
    - Certification Construction completion and request for a letter of   Clearance to Place a Public Drinking Water Facility
      into service.
  • pbchd_ecrII-12-2-a.pdf
    Application for:
    - Permit to Construct an Onsite Water Distribution System
      Regulated Under Palm Beach County
      Environmental Control Rule II
     
  • pbchd_ecrII-12-3-a.pdf
    Application for:
    - Certification of Construction Completion and Request for a
            Letter of Clearance to Place an Onsite Water Distribution    System into Service for Systems

Wastewater Systems

 

Permitting Release Requirements


Application/Forms  Prefix & Terms explained:

Prefix
-
dep - (Department of Environmental Protection)
- pbchd - Palm Beach County Health Dept. Forms
- doh  - State of Florida Department of Health Forms
- der  - (Department of Environmental Regulation)

Terms
  n/a

 

PERMIT FORMS

Public Water Supply and Wastewater Systems
FORMS

Septic Tanks (OSTDS) and Private Drinking Water Wells FORMS

Solid, Hazardous & Biomedical Waste Control

Public Swimming Pools
FORMS

Child Care
Family Day Care FORMS

Body Piercing FORMS

Air Quality


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Click for Health Department Publications Available Online!!

Palm Beach County Health Department  - www.pbchd.com Florida Dept. of Health (DOH) - www.doh.state.fl.us - opens a new window
        http://www.pbchd.com/                        http://www.doh.state.fl.us/

MyFlorida.com - www.myflorida.com - opens a new window  Automated Community Connection to Economic Self-Sufficiency   Welcome to the Florida Community Health Assessment Resource Tool Set (CHARTS).  It is our hope that you will find Florida CHARTS informative and easy to use. This site includes such health statistics as births, deaths, disease morbidity, population and behavioral risk factors. - opens a new window  Jobs within the State of Florida - State Job Search - opens a new window

Florida Health Stat - opens a new window   The Agency for Health Care Administration - opens a new window   Ten-year plan to end homelessness in Palm Beach County - opens a new window

http://www.floridakidcare.org/ - opens in new window The Health Care District has launched a new program called Vitahealth.  This is a low cost policy for residents of Palm Beach County who have no health insurance coverage or have lost their coverage for over 6 months.  Details are available by calling 866-930-0035 or on the web at www.vitahealth.org

The Adobe Acrobat Reader software is available for nearly any operating
system, and is a free download from Adobe's website

Visit Adobe for your copy of Acrobat Reader to view and read pdf files. - opens a new window

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PBCHD P.O. Box  29 West Palm Beach, FL 33402
For general questions, information, or health-related issues,
call (561) 840-4500 or use a feedback form under Contact Us.