EmailMeForm
Request for Environmental Health Records
Rowan County Environmental Health Department
Today's Date
*
MM
/
DD
/
YYYY
Name of Requester
*
First
MI
Last
Email
*
Daytime Phone
*
###
-
###
-
####
Fax Number:
###
-
###
-
####
Physical Address of Property:
*
Street Address
City
State / Province / Region
Postal / Zip Code
Tax map/Parcel ID Number:
*
Type of Record Requested (Check and complete all sections that apply)
Septic System
Well
Year Installed:
Original property owner (when system was installed):
Current Owner:
Building Contractor (if known):
Record Requests will be responded to in order of receipt. Requests may take two business days to be completed. All efforts will be made to respond to requests on the same day.