Forms & Fees

The following forms and fees may be downloaded from this website or may be obtained by contacting the Oneida County Health Department at:

Postal Delivery: 185 Genesee Street - 4th Floor - Utica, NY 13501
Phone: 315-798-5064 - Toll-free in NYS: 1-800-541-0151 ext. 5064
Fax: 315-798-6486
Email: environmentalhealth@ocgov.net

General Forms

                Word .doc Format Adobe .pdf Format
Clean Indoor Air Act Waiver Application   download
Clean Indoor Air Act Enforcement Policy   download
Clean Indoor Air Act Waiver Policy   download
Permit Application   download
Permit Application Instructions   download
Permit Fee Schedule    download
Plan Review Fee Schedule   download
New Workers' Compensation / Disability Insurance Requirements download  
Freedom of Information Law request forms (FOIL)    download
NYS DOH Codes - list with links  download  
Guidance for Temporary Events - Mass Gatherings  download  
Animal Bites / Rabies Report Form  download  
Voucher for Oneida County    download
Voucher Instructions    download
     
Engineering/Design Forms Word .doc Format Adobe .pdf Format
Notice of Intent to construct, enlarge, or convert for occupancy or use (DOH 154) download download
Application for Approval of Backflow Prevention Devices (DOH 347)   download
     
Application for a Certificate of Approval of Plans to Interconnect Water Systems (DOH 351) download  
Specific Waiver from Appendix 75-A Requirements (Septic) (DOH 1326) download download
PWS Plan Application (DOH 348) download (excel)  download
Percolation Test Data (DOH 1327) download download
Application for Approval of Sanitary Facilities for Realty Subdivisions   download
Acceptable Gravelless Absorption Trench Products   download
Realty Subdivisions Applicant's checklist    download
Sanitary Privy    download
Subdivision Map Requirements    download
List of Professional Engineers & Registered Architects (OC-15)   download
Children's Camps Forms    
Swimming Pools/Bathing Beaches Forms    
Drinking Water Protection Program Forms    
Water Systems Operation Report - call Oneida County Health Department Water Supply Program 315-798-5064    
Reporting Emergency Changes in Public Water Systems (DOH 358) - call Oneida County Health Department Water Supply Program 315-798-5064 download  
Local Laboratories (water testing)