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2. Environmental Health Documentation Request Form

   If you would like to request information regarding a septic plan, site assessment, or other record, please complete the following form. Upon completion, you will receive an email confirmation and a staff member will contact you regarding your request within ten business days.

4. First and Last Name*
5. Email Address*
7. Address*
8. City*
10. State*
11. Zip Code*
12. Phone Number*
14. Type of Documentation Requested:*
    -- Select One --Septic PlanSite AssessmentFood Service InspectionOther record (please describe below)
16. If you selected other in the previous question, please describe what you are requesting.
18. Address of information requested for septic plan/site assessment/other.*
20. City*
21. State*
22. Zip Code*
24. We thank you for your patience during this time. For further information, please contact the City of Nashua DPHCS Environmental Health Department by calling 603-589-4530 or emailing eh@nashuanh.gov.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field