Caroline County Health Department, Maryland

Caroline County Health Department
Division of Environmental Health - Hours 8-5p.m., M-F; Phone: 410/479-8045
403 S 7th Street, P.O. Box 10, Denton, MD 21629

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Instructions for completing the soil and site evaluation application

Before completing the application read "Soil and Site Evaluation General Information" and "Site Preparation."
Select and install piezometers before applying and paying fees. The “pit” test will be scheduled; wait for this office to contact you to prepare the site.
Submit a copy of the record plat and a site plan showing test locations to scale, (1” = 30’, 40’, 50’) All lot corners and test sites must be accurately and clearly marked in the field.
If subdividing, submit a copy of Planning and Codes’ preliminary subdivision review results. Please review the “Minor” or
“Major” subdivision requirements.

A) Owner’s name and mailing address: This is where the perc results will be sent. Note day phone number(s). Email addresses will be processed faster as they will not be required to be “snail mailed”.

B) Property Description: Information can be obtained from tax records; such as Map, Block/Grid, Parcel numbers. Also note in this section if property is in Critical Areas, Ag Preservation or Forestation areas—check with Planning and Codes at 410 479 8100.

C) Residential Proposal: check appropriate box. Residential Fees: check appropriate box, note number of sites and calculate fee due, make check payable to “CAROLINE COUNTY HEALTH DEPARTMENT”

D) Commercial Proposal: complete this section if commercial site, check appropriate box and fill in GPD (gallons per day) and calculate fee—make check payable to “CAROLINE COUNTY HEALTH DEPARTMENT”

E) Water Supply: Check appropriate box (note if you check “Public” please note what town providing public water.

F) Authorization: Read conditions in this section before signing—if applicant not the property owner attach an "Authorization Form" signed by the legal owner, or a handwritten authorization (letter) from the owner permitting the applicant to apply for a perc test on this property.

G) Owner’s signature is required.