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How to use or fill out DH 4016 (page 3) pdf form - Florida Department of Health
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the Permit # assigned by the Health Department at the top of the form.
- Fill in the Applicant's full name and the Master Septic Tank Contractor's details, including their registration number.
- Complete the property address, including Lot, Block, and Subdivision information as applicable.
- For each tank (Tank 1 and Tank 2), indicate if it is new or existing, then provide details on size, material, and any outlet filters installed.
- Repeat similar steps for Grease Trap and Dosing Tank sections, ensuring to specify pump details where necessary.
- In Fields 1 and 2, provide information about drainfields including size, number of pipes/trenches, and elevation data.
- Complete sections for Aggregate, Fill, Excavation, Setbacks, Abandonment dates if applicable.
- Finally, add any remarks regarding repairs or modifications before signing and dating the certification section.
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See more DH 4016 (page 3) pdf form - Florida Department of Health versions
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2009 | 4.6 Satisfied (64 Votes) |
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