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San Juan County Health Department
735 S 200 W Suite 2, Blanding, UT 84511
Phone: (435) 587-3838
sanjuanpublichealth.org
Recertification For Septic
Date
Home Owner's Name
Location of Home
Contact Phone Number
Contact Person if different than owner
Approval letter to go to the following:
Establishment Information
Organization Name:
Address:
Address:
City:
State/Province:
ZIP/Postal Code:
Phone:
Email:
Select Requested Services
Septic Recertification:
$78.00
Select:
Item Subtotal:
$0.00
Total:
$0.00
Payment Information:
Processing Fee Rates:
Cards:
2.5% ($1.50 min)
(1.5% additional service fee for foreign cards)
eCheck:
$0.75
Method of Payment:
Credit/Debit Card
eCheck
Update Name from Above
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
Payment method will be collected on external device
Change Payment Method
Submitting ...
Cancel
Date
is required
Home Owner's Name
is required
Location of Home
is required
Contact Phone Number
is required
Organization Name: is required
Address: is required
City: is required
State/Province: is required
ZIP/Postal Code: is required
Phone: is required
Email: is required
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