Animal Encounter:

SG-58 Animal Encounter Report Form

Body Piercing/Tattoo Studios:

SG-49 Application for Permit to Operate

SG-86 Piercing Studio Plan Review

SG-88 Piercing Technician Certification Application

SG-89 Information & Notification

SG-90 Hepatitis B Declination

64-80A Body Piercing Studio Rule Public Notice

Child Care Centers:

SG-49 Application for Permit to Operate

SG-99 Plan Review Information for Child Care Centers (New or Remodeled)


SG-51 Complaint Form

You can also fill out the Online Complaint Form  

Food Sanitation:

SF-5 Food Establishment Permit Application

SF-7A Food Guide

SF-7B Equipment Guide

SF-7C Management and Personnel Guide

SF-7D Employee Health Guide

SF-7E Inspection Guide

SF-35 Plan Review for New or Remodeled Food Establishments

SF-35 Addendum: Information Packet

Form 1-A Applicant Food Employee Interview

Form 1-B Food Employee Reporting Agreement

Form 1-C Applicant and Food Employee Medical Referral

PHSD Retail Food Emergency Flip Chart

General Sanitation:

SG-49 General Sanitation Permit Application

Manufactured Home Community:

SG-49 Application for Permit to Operate

EG-1 Manufactured Home Community Specification and Plan Review Summary Form

EG-2 Application for a permit to Construct, Install, Alter, or Extend a Manufactured Home Community

EG-4 Sewage System Information and Design Data Sheet

EG-5 Water System Design Information and Data Sheet

Recreational Water Facilities:

SG-49 Application for Permit to Operate

ER-32 Recreational Water Facility Weekly Report

SR-153 Recreation Water Facilities Tables

Swimming Pool & Spa Construction Application


SS-182A Application to Install or Modify a Small Sewage Disposal System

ES-57 Affidavit


     Home Loan Evaluations:

     SG-55 Home Loan Evaluation Report

     SG-55A Home Loan Evaluation Procedures


     Subdivision Forms:

     ES-76 Subdivision Application


     Septic Tank Cleaner Forms:

     SS-181 Application For Sewage Tank Cleaning Permit


     For Installers Only:

     SS-192 Installer Certification Renewal Application


SW-252c Springs

SW-252d Cisterns

SW-252e Installing a Hand Pump

SW-252g Pitless Units

SW-253 Request for Water Analysis

SW-256 Water Well Application

SW-258 Water Well Completion Report

SW-260 Water Well Variance Request

SW-261 Water Well Abandonment Report

SW-262 Water Well Pump Installation Report

Water Quality Labs

Private Water Well Owners–What to Do Before Drilling the Well

Private Water Well Owners–Water Well Pumping Systems

Private Well Owners-Four Steps to Water Well Safety

How to Disinfect a Private Water Well

All Applications and Forms are in PDF format and require that your computer be running Adobe® Acrobat Reader software.

Please Note: If you experience difficulty in downloading or printing forms, please refer to the Adobe Web Site for troubleshooting and support guidelines.

If you have any questions or concerns, please contact us for further assistance.

Applications and Forms


60 Pennsylvania St

West Union, WV 26456