DFS 319 Test | Woodford Co. Health Department

Woodford County Health Department

Hours of Operation

Monday-Tuesday-Thursday 8:00 am - 4:30 pm
Wednesday: 8:00 am - 6:00 pm
Friday: 8:00 am - 12:00 Noon
Saturday: Closed
Sunday: Closed

Environmental Office Hours

Monday - Thursday 8:00 am - 9:30 am and 1:00 pm - 1:30 pm
Friday - 8:00 am - 9:30 am
By appointment only. Please call Barrett Schoeck's cell @ 859-753-8119

Plumbing Inspector Hours

Monday 8:00am - 9:30am

229 North Main St. Versailles, KY 40383

☎ 859-873-4541

Disaster Planning/MRC/Cert

Health Resources

Recalls

Employment

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CABINET FOR HEALTH AND FAMILY SERVICES DEPARTMENT FOR PUBLIC HEALTH APPLICATION FOR PERMIT/LICENSE

Step 1 of 4

DFS-200 (Rev. 06/18)
CABINET FOR HEALTH AND FAMILY SERVICES DEPARTMENT FOR PUBLIC HEALTH APPLICATION FOR PERMIT/LICENSE
Application for permit/license to operate a:

Facility Profile: Permit/License Fee

Inspection Fee

Total

Date Paid:
MM slash DD slash YYYY

Check
Check
Cash
Cash
Money Order
Money Order
Establishment No.

Program:

County:

Action:
New
Change
Deleted
Reactivate
Status:
Active
Inactive
Hold
No. App
Suspended
Sanitarian Number:

Inspection Interval:

Type of Est.:

Type of Service:
Sit Down/Full
Caterer(Comm.)
Cafeteria/Continental
Insterstate Conveyance
Carry-Out/Retail Market
No Service Type
Water Supply:
Public
Private
Other
Sewage:
Public
Private
Other
Federal ID:

Census Tract:

TO BE COMPLETED BY APPLICANT – PLEASE PRINT LEGIBLY
Name of Establishment

Sort Name (Leave Blank): _______________________________________
Address
Street Address City State ZIP Code

Owner's Name:

Last 4 SSN

Mailing Address:
Street Address City State ZIP Code

Phone #
Home Phone:

Cell Phone:

Email:

Billing Address (if different from above)
Street Address City State ZIP Code

Phone #
Military Status
Active Duty
Reserves
National Guard
Honorably Discharged Veteran
I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me for permits or licenses.
Applicants Signature:
Date
MM slash DD slash YYYY

Establishment GPS Coordinates
Latitude
DEG MIN SEC
Longitude
DEG MIN SEC

Unit Measure

Machines A

Mobile Home Spaces M

Rooms R

Seats S

Trucks T

Gallons G

Boarders/Beds B

Machines (Quantity)

Machines (Quantity)
Mobile Home Spaces (Quantity)

Mobile Home Spaces (Quantity)
Rooms (Quantity)

Rooms (Quantity)
Seats (Quantity)

Seats (Quantity)
Trucks (Quantity)

Trucks (Quantity)
Gallons (Quantity)

Gallons (Quantity)
Boarders/Beds (Quantity)

Boarders/Beds (Quantity)

Unit Measure

Commisaries C

RV Spaces V

Feet F

Male Student M

Female Students E

Residents R

Square feet Q

Commisaries

Commisaries (Quantity)
RV Spaces

RV Spaces (Quantity)
Feet

Feet (Quantity)
Male Student

Male Student (Quantity)
Female Students

Female Students (Quantity)
Residents

Residents (Quantity)
Square feet

Square feet (Quantiy)
Catering Operation
Catering Operation
Drive Through Window
Drive Through Window
Variance
Variance
Planned Construction No.

Language

Language
Menu Type

Menu Type
Risk Type

Risk Type
State Owned
State Owned
Fee Paying
Fee Paying
WIC
WIC
Print Permit
Print Permit
Roster
Roster
Truck Only
Truck Only
Home County

Group ID

Pool Information
Indoor
Outdoor
Continuous
TOR

Disinfectant Type

Pump

Filter

Bond Information
Insurance Company
Individual
Bond Needed
Not Required
Cancelled
Septic Tank Trucks
Number Make Model Year Capacity

Construction Plan Approval
Construction Plan Approval
New or Additional Plumbing Construction Approval
New or Additional Plumbing Construction Approval
By

Health Authority

Date
MM slash DD slash YYYY

CAPTCHA

ONSITE SEWAGE DISPOSAL SYSTEMS APPLICATION FOR SITE EVALUATION

Hidden
Application No.

Application No.
Hidden
Date Received

Date Received
Hidden
County

County
TO BE COMPLETED BY APPLICANT
Applicant's Name

Applicant's Name
Owner's Name (if different)

Owner's Name (if different)
Present Address

Phone
Email

Location of Property

Acreage / Lot #

Hidden
ATTACH TO THIS APPLICATION THE FOLLOWING
1. Location map to reach site.
2. Site drawing showing property lines and dimensions of same; location of existing structures; wells, ponds, streams, gullies, swamps, etc..; easements, roads, drives, right-of-ways; if present.
3. Proposed (or existing) location of structure(s) to be served by the system; proposed system location.
TYPE OF STRUCTURE PROPOSED
Single Family Res.

Single Family Res.
# of BR?

# of BR?
Garbage Disp?

Garbage Disp?
Basement?

Basement?
Commercial
Commercial
Type of Business

Public Facility
Public Facility
Type of Facility

# of Design Units
# of Design Units
Gallons/Unit/Day

Gallons/Unit/Day
Total Daily Wasteflow
Total Daily Wasteflow
For commercial and public facilities, refer to Table 1, Section 8. System sizing standard (pages 49-52) of 902 KAR 10:085 for design daily waste flow sizing based on type of facility.
X I (or my designated agent),
wish to be present during the site-evaluation.

wish to be present during the site-evaluation.
I do not wish to be present during the site-evaluation, and waive this right.
I, do not wish to be present during the site-evaluation, and waive this right.
TO BE COMPLETED BY LOCAL HEALTH DEPARTMENT
*Evaluation Fee $ 200.00 Date for Evaluation: 2020
Paid By: Cash Check # Time: AM/PM
CAPTCHA

WCHD CONFIRMS MULTIPLE CASES OF COVID-19 IN WOODFORD COUNTY

Visit our Facebook page for the most up-to-date information regarding confirmed cases: https://www.facebook.com/woodfordhd/

While the risk to the general public is low, health officials are working with the Centers for Disease Control and Prevention (CDC) and Kentucky Department for Public Health (KDPH) to identify and notify all those who may have come in contact with the infected individuals. These individuals will be monitored for fever and respiratory symptoms.

Additional details about the persons affected cannot be provided due to medical privacy laws.

“At this time, we believe the risk to the general public is low, and as this situation evolves, we will continue to communicate with the CDC, KDPH and the people of Woodford County,” said Cassie Prather, Woodford County Public Health Director. “The best way to prevent illness is to avoid being exposed to this virus. However, there are everyday preventative actions you can take to help prevent the spread of this virus.”

The health department offers these tips:

Wash your hands often with soap and water, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.

Avoid close contact with people who are sick.

Avoid touching your eyes, nose and mouth.

Stay home when you are sick.

Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

The virus is thought to spread mainly from person-to-person:

Between people who are in close contact with one another (within about 6 feet).

Via respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Stay up to date at: www.kycovid19.ky.gov and https://www.facebook.com/woodfordhd/

Woodford County Restaurant Update

Kentucky Gov. Andy Beshear on Monday announced that he plans to order all restaurants in the state to close to dining-in, beginning at 5 p.m. Monday, March 16, 2020.

Closing restaurants and bars to in-person service

Gov. Beshear said he will direct restaurants and bars to close, although there will be expectations for drive through and delivery. The Governor urged people to order take out when possible and support local businesses and their employees.

“We are to the point now where this is a step we have to take. I want to thank everyone that stepped up and did this voluntarily,” he said. “We are asking so many people to make sacrifices. It is not lost on me that most of these are small businesses. We are going to do everything we can to be there for you. We realize the impact this will have and we will be there for you.”

PROGRAM MODIFICATION UPDATE

Beginning Tuesday, March 17, 2020, our office will be open but will only be taking phone calls and answering emails. We will be providing essential services in-person, on an as-needed basis. Our focus is shifting to provide information to our healthcare community, provide resource management for the county, and provide epidemiological investigations.

We will do our best to maintain as many services as possible via telephone. If you are a participant of WIC or HANDS, please call us for additional guidance on how we can serve you in a way that protects your safety and wellbeing. Other services will be evaluated on an individual basis, and we will do our best to make them available as needed. We will offer as many services as possible while keeping limited contact with our clients.

The environmental office will be open on Monday mornings (until further notice) from 8-9:30 am while the plumbing inspector is open. Otherwise, please call and leave a message. At this time, we will be focusing on investigating complaints.

We are working diligently with CDC and the Department for Public Health to keep Woodford County healthy and safe. Please understand that we will do our best to make necessary services available to our community while also protecting the health of our staff.

Our phone number is (859) 873-4541. We can also be contacted via Facebook. Please be patient and understanding. We are all trying to figure out how to work under these unusual circumstances. Thank you in advance for your cooperation.

ISOLATION SURVEY