Food Service Establishment Sewage Treatment System Determination Form
Form required when a food service establishment intends to use an existing or new sewage treatment system, allowing CCHD to determine whether the system is new or replacement and whether engineering plans are required.
- Jurisdiction
- Clinton County, New York
- Fields
- 42
- Includes
- Signatures
Create a free account to fill this form, sign it and download it ready to file. No card needed.
- Your answers print onto the health department's own PDF
- Sign on screen: phone, tablet or laptop
- Save it and come back to it
Fill it online
Type into the real county form. No printing, no retyping.
The county's own PDF
Your answers print onto the health department's document, not a lookalike.
Download and file
Get the finished PDF and hand it in exactly as they expect it.
What this form asks for
Have these to hand before you start.
- Your Name
- Date
- Address
- Contact Information: (Phone, E Mail)
- Meet At The Health Department
- By Phone
- By E Mail
- By Mail
- I Do Not Wish To Be Contacted
- Date The Event Took Place
- Program
- Name(S) Of Health Department Staff Involved
- What Did You Like? What Did You Dislike?
- Tell Us About Our Service (Line 2)
- Tell Us About Our Service (Line 3)
- Tell Us About Our Service (Line 4)
- What, If Anything, Should We Do Differently?
- What, If Anything, Should We Do Differently? (Line 2)
- What, If Anything, Should We Do Differently? (Line 3)
- What, If Anything, Should We Do Differently? (Line 4)
- What Do You Expect Us To Do With Your Input?
- What Do You Expect Us To Do With Your Input? (Line 2)
- Action Taken (Line 1)
- Action Taken (Line 2)
…and 18 more.
Where it goes
Submit to Clinton County Health Department Environmental Health and Safety division at 135 Margaret Street, Plattsburgh, NY 12901; note this URL resolves to a guide document that embeds the form, verify it is the fillable form before use.
Filed with septic@clintoncountyny.gov.
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