Forms & Applications Page

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Consumer Protection Programs

     Food Protection
     
General Food Forms & Applications
      Mobile Food Facilities
      Community Event Organizer
      Temporary Food Facilities
      Cottage Food Operations Forms

        Recreational Health
        Public Pools & Spas

        Body Art
        Tattoos

Land & Environmental Programs

            Biosolids
            Land Use Survey 
            
Sewage Disposal/Septic  

                Solid Waste
                Drinking Water
                Ground Water Protection

Hazardous Material Programs

Aboveground Storage Tanks (AST)
California Accidental Release Prevention (CalARP)
California Environmental Reporting System (CERS)
Hazardous Materials/Hazardous Waste
Monitoring wells & Soil Borings
Well/Septic Systems
On-site Hazardous Waste & Treatment
Underground Storage Tanks (UST)
Additional UST Forms

Miscellaneous Forms

Complaint Form
(Non-Housing

Housing Complaints
(within city limits)

Substandard Housing Complaint Form
(Unincorporated areas of Yolo County)

Request for Service

 

CONSUMER PROTECTION PROGRAMS  

FOOD PROTECTION PROGRAM

Permit Application
(Food Service Establishments)

Veteran's Fee Exemption Form

Plan Check Review Application
(Retail Food Facilities)

Non-Profit Exemption Form

Plan Review Checklist
(Retail Food Facilities)

Hot Holding Temperature Log

Mobile Food Facility

Mobile Food Application Package

Mobile Food Commissary Agreement

Mobile Food Application Package
(Spanish)

Mobile Food Restroom Agreement

Community Event Organizer

Community Event Forms & Application Package

Non-Profit Exemption Form

 Temporary Food Facility

Temporary Food Forms & Application Package

Non-Profit Exemption Form

Cottage Food Operations Forms

Registration Permit Form
(Class A and B)

Self-Certification Form
(Class A only)

 

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RECREATIONAL HEALTH (POOL AND SPA)

Pool/Spa Health Permit Application

CCDEH Guidelines for Water Parks

Recreational Health Facility Plan Review Guide

CCDEH Guidelines for Spraygrounds

California Pool Code

CCDEH Guidelines for Water Slides

Pool & Spa Inspection Checklist

Pool/Spa Daily Maintenance Log

California Department of Public Health AB1020 Compliance Form

Drain Cover Replacement Certification Form

 

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BODY ART

Perform Tattooing, Body Piercing, or Permanent Cosmetics

 Practitioner Registration Application

Facility Permit Application

Infection Prevention and Control Plan Guideline 

Hepatitis B Declination Statement

Approved Bloodborne Pathogen Training Course

Sharps Mail Back List

 

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LAND & ENVIRONMENTAL PROGRAMS

BIOSOLIDS

Biosolids Permit

Biosolids Checklist 

 

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SEWAGE DISPOSAL

Septic System Installation Permit Application

Septic Abandonment Permit Application

Typical Process for Designing and Installing a New Septic System

Septic System Contractors

Site Evaluation/Soil Profile Request Form
Septic System Variance Application 
 Septic System Setbacks Septic System Designers/Qualified Professionals

 

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 SOLID WASTE

 Enforcement Agency Notification
(CIWNB Form 169)
Word File         PDF File

 Registration Permit Application
(CIWMB Form 83)
Word File         PDF File

 Solid Waste Facility Permit Application
(CIWMB Form E-1-77)
Excel File         PDF File

 Directions for Completion of Form E-1-77
Word File         PDF File

Standardized Permit Application
(CIWMB Form 92)
Word File         PDF File

 

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DRINKING WATER PROGRAM

Bacteriological Sample Siting Plan

Domestic Water Permit

Emergency Notification Plan

Operational Requirements

Permit Amendment Application

Regulations Excepts

Well Completion Report

TMF Assessment

 

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GROUND WATER PROTECTION/ WELL PERMITS

Water Well Application Form

Well Plot Plan

 Water Well Setbacks  Water Well Abandonment Application Form

 

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HAZARDOUS MATERIAL PROGRAMS
 

ABOVEGROUND STORAGE TANK

Daily Inspection Log for Tank Systems

Tier I Qualified Facility SPCC Plan Template

Tier II Qualified Facility SPCC Plan Template

 

 CALIFORNIA ACCIDENTAL RELEASE PREVENTION

 Please visit  the CERS webpage to upload/update all forms online

Annual Renewal Certification

Consolidated Contingency Plan

Instructions for all of the CUPA forms

Site Map (Excel)/(PDF)

HAZARDOUS MATERIALS/HAZARDOUS WASTE BUSINESS PLAN & INVENTORY 

Please visit the CERS webpage to upload/update all forms online

Consolidated Contingency Plan

Site Map (Excel)/(PDF)

Financial Responsibility & CFO Letter

Annual Renewal Certification

Training Documentation Form
(used to log employee training)

Ag Facility Exemption
(Farm Exemption Application)

Ag Cover Letter
(Farm Exemption Cover Letter )

All CUPA Instructional Forms

Site Map (Excel)/(PDF)

Consolidated Contingency Plan

 

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MONITORING WELLS & SOIL BORINGS

Monitoring Wells & Soil Borings
Permit Application
For projects on multiple parcels a separate permit application is required for each parcel.

***ADDITIONAL requirements for a Monitoring well and/or Soil Boring Permit***
The additional documents in the link above
MUST be attached to the permit application upon submission or else the application will be rejected.

 General Permit Conditions for Monitoring Well & Soil Borings
Monitoring Well & Soil Boring Permit Conditions

 

ON-SITE HAZARDOUS WASTE TREATMENT

On-site Hazardous Waste Treatment Unit Forms This document contains several pages. For each treatment unit, submit the first page and one of the additional pages depending on the type of treatment unit this notification is for. The treatment types are: Waste Treatment Unit
  • Conditionally Exempt - Small Quantity Treatment (CESQT)
  • Conditionally Exempt - Specified Wastestream (CESW)
  • Conditionally Authorized (CA)
  • Permit By Rule (PBR)
  • Conditionally Exempt - Limited (CEL)

Download the Hazardous Materials Business Plan Packetself-executable zip

Recyclable Materials Report
(only facilities that recycle more than 100 kg/month of excluded or exempted recyclable materials)

On-site Hazardous Waste Treatment Facility Form 
 (one form per facility and the Waste Treatment Unit Forms below)

 Certification of Financial Assurance

Remote Waste Consolidation Site Annual Notification

Haz Waste Tank Closure Certification

 CUPA Forms Instructions

 Consolidated Contingency Plan Manual
(Click Read-Only to view the manual)

 Business Activities Page

Business Owner/Operator Identification

Consolidated Contingency Plan
(click "yes" when asked to view file as read only)

Hazardous Material Inventory Report Form

Annual Renewal Certification

 

UNDERGROUND STORAGE TANKS

UST Installation/Modification Forms:

 

Change of Ownership Forms:

 

UST Repair Modifications Packet :

 

UST Permanent Removal Packet:

 

UST Abandonment in Place Packet:

 

UST Temporary Abandonment Packet:

 

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ADDITIONAL UNDERGROUND STORAGE TANK FORMS

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