California department of public health food and drug branch water hauler license form 2026

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The document is a Water Hauler's License Application form from the California Department of Public Health, outlining the requirements for new applicants, renewals, and changes in ownership or vehicle information. It includes sections for firm details, facility addresses, contact information, vehicle specifications, and potable water sources. The application requires a non-refundable fee and must be completed fully to avoid rejection.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Name of Firm' section with the full name of your business. If applicable, include any additional names under 'DBA'.
Complete the 'Facility Address' fields with the number, street, city, state, and ZIP code for your facility location.
If your mailing address differs from the facility address, provide that information in the 'Mailing Address' section.
Fill in contact details such as 'Facility Operator', telephone numbers, and email address to ensure clear communication.
Indicate your type of ownership and list all vehicle license numbers along with their respective VINs in the designated sections.
Finally, review all entries for accuracy before signing and dating the application at the bottom.

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