Get Mdard Well-septic Request Form Master Revision 7-11- 2014 - Michigan

The Mdard Well-Septic Request Form is essential for food establishments in Michigan to ensure compliance with local water supply and wastewater system regulations. This guide will provide you with a clear and step-by-step approach to filling out the form online, assisting you in navigating each section effectively.

Follow the steps to complete your Mdard Well-Septic Request Form online

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by completing Section 1 for your MDARD use. Here, provide the establishment name, license number, owner's name, establishment address, and contact number. Indicate the city, ZIP code, and specify the review requested — either the on-site water supply system or the on-site wastewater system.
3. Next, specify the establishment type by selecting from options such as retail grocery, dairy farm, processor, food service, or other. Additionally, describe how water is used within the facility, including relevant activities such as food preparation or employee counts.
4. In Section 2, reserved for LHD use, outline the basis for the water supply system and wastewater system review. Indicate whether the reviews were based on records review, on-site review, or both.
5. Record the initial review recommendations as A, B, or C, and indicate whether the water supply system is satisfactory for its proposed use. Include any necessary corrections to elevate the recommendation level, and document the classification type (Type II or Type III) and reasons for your classification.
6. Provide details regarding water sample results, noting if bacteriological results are acceptable. If any known water quality problems exist, describe actions taken to resolve them.
7. Complete a summary regarding the wastewater system, including whether it is satisfactory for proposed use and any required corrections. Document any permits obtained or corrections made, along with the agency's contact information.
8. Finally, review the entire form for completeness and accuracy. Save any changes, and print, download, or share the completed form as necessary. Ensure to submit the form via email to the designated MDARD inspector as instructed.

Take action now by filling out your Mdard Well-Septic Request Form online for a seamless review process.