Forms & Applications

Food Service Applications, Forms, & Regulations
Name: Description:
Foodservice Permit Application Application for a Virginia Department of Health Foodservice Establishment Permit
Plan Review Application Application for Virginia Department of Health Plan Review
Plan Review Checklist/Comprehensive Guide Plans to review for approval before Food Establishment Permit
VA Food Regulations Virginia Department of Health Food Regulations
VDH Recognized Food Protection Manager Certifications List of Virginia Department of Health recognized Food Protection Manager Certification opportunities
Food Safety List of Food Safety resources and information
Mobile Unit Checklist Virginia Department of Health required Mobile Unit conditions Checklist
Fire Requirements Virginia Department of Health required Mobile Unit, & TFE Fire Regulations
Fire Safety Powhatan Fire Safety Instructions for Mobile & Temporary Units
Temporary Food Establishment Application

Event Coordinator Application

*These forms can be emailed to Powhatan_eh@vdh.virginia.gov.
Once the application has been submitted, please call (804)598-5680 to pay the $40 fee using Visa or Master card. Payments may also be received by mail or in person at

3908 Old Buckingham Rd

Unit 1

Powhatan, VA 23139

 Applications for a Temporary Food Establishment, & Temporary Event which must be submitted 10 business days prior to an event
TFE Checklist Checklist of requirements for a Temporary Food Establishment
Requirements Policy Chesterfield Health District Application & Requirements Policy for TFEs

Fees effective as of July 1, 2011

Program Plan Review Fee Annual Permit Fee
Hotels/Motels $40 $40
Restaurants $40 $40
Summer Camps $40 $40
Campgrounds $40 $40
Temporary Food Permit $40 Annual Permit Fee

 

Hotel, Summer Camp, Campground, & Migrant Labor Camp Applications, Forms, & Regulations
Name: Description:
Hotel Permit Application Application for a Virginia Department of Health Hotel
Hotel Plan Review Application Application for a Hotel Plan Review
Sanitary Regulations for Hotels Virginia Department of Health Sanitary Regulations for Hotels
Chapter 460. Regulations Governing Tourist Establishment Swimming Pools and Other Public Pools Virginia Department of Health Regulations for Tourist Establishment Swimming Pools
Chapter 462. Swimming Pool Regulations Governing the Posting of Water Quality Test Results Virginia Department of Health Regulations for Posting Water Quality Test Results
Campground Application

Application for a Campground Plan Review

 Applications for a Virginia Department of Health Campground Permit & Plan Review
Summer Camp Application Application for a Department of Health Summer Camp Permit
Migrant Labor Camp Permit Application Application for a Migrant Labor Camp Permit
Chapter 501. Rules & Regulations Governing the Construction & Maintenance of Migrant Labor Camps Virginia’s Legislative Informative System, Chapter 501. Rules & Regulations Governing the Construction & Maintenance of Migrant Labor

 

Onsite Sewage (Septic) & Well Water Program
Name: Description:
Commonwealth of VA Septic & Well Application Application for Sewage System & Water Supply
SAP Application Safe, Adequate, & Proper (SAP) Application
Survey Plot Waiver Request for a Waiver to the Survey Requirement
Verification of System Location Documentation Verifying Sewage System Location
Temporary Pump & Haul Application for Pump & Haul
Sewage Handler Application for Sewage Handling Permit
Find an Operator, OSE VDH Septic System & Private Well Service Providers
VDH Water Services VDH Description of On-Site Water & Wastewater Services

 

APPLICATION TYPE FEE (effective July 1, 2019)
Certificate letter, no OSE/PE documentation (no charge for well) $350
Construction permit for onsite sewage system only, no OSE/PE documentation $425
Certification letter with OSE/PE documentation, < = 1,000 gpd $320
Certification letter with OSE/PE documentation, > = 1,000 gpd  $1,400
Construction permit for only onsite sewage system with OSE/PE documentation, < = 1,000 gpd $225
Construction permit for only onsite sewage system with OSE/PE documentation, > = 1,000 gpd $1,400
Private well only, with or without OSE/PE documentation $300
Repair permit for a treatment works, < 1,000 gpd with OSE/PE documentation $425
Repair permit for a treatment works, < 1,000 gpd with OSE/PE documentation $225
Repair permit for a treatment works, > 1,000 gpd with OSE/PE documentation $1,400
Voluntary Upgrade for a treatment works, < 1,000 gpd with OSE/PE documentation $225
Voluntary Upgrade for a treatment works, > 1,000 gpd with OSE/PE documentation $1,400
Safe, adequate, and proper evaluation with OSE/PE/Installer/Operator Documentation $100
Last Updated: August 2, 2022