Commonly Requested Environment Health Documents and Forms

The following are links to Environmental Health Forms from the Elkhart County Health Department. Forms are also available on the individual subpages for download. To access the forms, click on the links below.

Commercial Swimming Pools

Emergency Response

Food Service Sanitation

Groundwater

Meth Labs

Insect, Vector, and Rodent

  • Stop Raising Mosquitoes- This pamphlet provides information on reducing mosquito breeding sites around your home.
  • Mosquito-Borne Diseases- This pamphlet contains information about several diseases spread by mosquitoes.
  • Ticks and Disease- This pamphlet provides information about several species of ticks and the diseases they can carry.

Septic and Well Froms

  • Application For Septic Permit- This form shows what information is required to apply for a septic permit. This form must be filled out in original and can be obtained at the Environmental Health Services Division office.
  • Plan Submittal Checklist- Septic System Plan Submittal for New, Repair/Replacement Onsite Sewage Disposal Systems.
  • Marking Utilities- This is an information sheet concerning the marking of utilities before construction and soil evaluations/soil borings.
  • ECHD Septic Ordinance Section 5
  • Septic Lookup Request- Use this form to request information on existing onsite sewage systems by fax or presenting to our office. Note: No information is available for homes/addresses constructed before 1967.
  • Sample "To Scale" Drawing- "To Scale" drawings are required with all application submissions for an onsite sewage disposal system permit.
  • Flood Dose Worksheet- This worksheet must be submitted at the time of application when minimum requirements indicate a flood dose installation.
  • Mound/Press Dist Worksheet- This worksheet must be submitted at the time of application when minimum requirements indicate an elevated sand mound system or pressure distribution system installation.
  • Onsite Evaluation Request- Use this form to request an onsite evaluation/soil boring from ECHD for residences. This form can be completed at the ECHD Environmental Health Services Office or printed, mailed, or faxed to our office at (574)875-3376.
  • Septic System Care and Feeding B- A guide from the EPA for the homeowner's care of their onsite system.
  • Development standards- Environmental Health Technical Review and Development Standards.
  • Wastewater Treatment Matrix- Wastewater Treatment Assessment Matrix
  • ECHD Septic Ordinance- Ordinance No. 2012-153
    An ordinance regulating private sewage disposal systems in Elkhart County.
  • Minimum Requirements
  • Septic Permit Procedure Guide- This guide explains obtaining a private sewage disposal system permit for new construction.
  • Installer Registration Form- This form registers septic installers in Elkhart County.

Fee Schedule

Lead

  • Protect Your Family- This pamphlet is an excellent resource. Landlords and sellers of homes built before 1978 are legally required to present this pamphlet to the new owners or tenants to warn about potential lead hazards in the home. This law applies even if the landlord or seller has no specific knowledge about lead hazards in the home (English).
  • Spanish Protect Your Family- This pamphlet is an excellent resource. Landlords and sellers of homes built before 1978 are legally required to present this pamphlet to the new owners or tenants to warn about potential lead hazards in the home. This law applies even if the landlord or seller has no specific knowledge about lead hazards in the home (Spanish).
  • Lead Paint Safety A Field Guide- This guide is part of HUD's approach to lead safety in the home. It will show you how to safely perform work around lead in a residence built before 1978 (English).
  • Spanish Lead Paint Field Guide- This guide is part of HUD's approach to lead safety in the home. It will show you how to safely perform work around lead in a residence built before 1978 (Spanish).
  • Reducing Hazards during renovation: This pamphlet is designed for contractors to help them determine what they can and cannot do when disturbing lead-based paint.
  • Prerenovation Education Rule- This brochure outlines the requirements for contractors, property managers, and others who perform renovations for compensation in residential housing that may contain lead-based paint.
  • Property Manager Responsibilities- This pamphlet is designed for landlords and apartment managers committed to providing a safe and habitable property for their tenants that complies with state and federal laws.
  • New Indiana Habitability English- This brochure details landlord obligations, liabilities, and disclosure rules for Indiana properties (English).
  • New Indiana Habitability Spanish- This brochure details landlord obligations, liabilities, and disclosure rules for Indiana properties (Spanish).
  • EPA and HUD disclosure- This brochure has questions and answers about federal lead disclosure laws.
  • Lease Disclosure English- EPA Title X requires landlords to disclose lead hazards by giving this form to tenants before leasing most residential homes built before 1978 (English).
  • Lease Disclosure Spanish- EPA Title X requires landlords to disclose lead hazards by giving this form to tenants before leasing most residential homes built before 1978 (Spanish).
  • Sale Disclosure English- EPA Title X requires sellers to disclose lead hazards by giving this form to buyers of most residential homes built before 1978 (English).
  • Sale Disclosure Spanish- EPA Title X requires sellers to disclose lead hazards by giving this form to buyers of most residential homes built before 1978 (Spanish).
  • Finding a qualified Lead Professional for Home- This pamphlet will help you find a lead professional who will tell you if your home has lead paint in a form that may pose a hazard to your children.
  • Lead Contractors and Home Testing- This is a list of regional and local lead contractors and appropriate cleaning and home testing suppliers.
  • Evaluating homes for lead hazards: This pamphlet is designed for the risk assessor, inspector, and clearance examiner to understand their role in evaluating the property and their responsibilities and better inform their clients.
  • Lead- Who's at risk?
  • Lead- Who's at Risk? Spanish
  • Elkhart County Lead Elimination
  • Consolidated Plan for Housing
  • Participation Interest Form, HUD- HUD Lead Grant Participation Interest Form

Records Request

  • Records Request- This form can request any public records from Environmental Health Services. Print this form and submit by mail, fax or deliver in person.