San Juan County Public Health
             
San Juan County Health Department
735 S 200 W STE 2, Blanding, UT, 84511
Phone (435) 587-3838

Application for Child Care Food Service Inspection
*Completed application must be received before an inspection will be scheduled.


Applicant's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

 
Child Care Food Service Inspection:      

*Inspection is by appointment only. Please allow up to 5 (five) business days for completion of inspection.
Our Environmental Health Director will contact you to schedule an inspection. 
Type of Inspection Requested:
Signature of Applicant
Date

 
First Name: is required
Last Name: is required
Address: is required
City: is required
State/Province: is required
ZIP/Postal Code: is required
Phone: is required
Email: is required
Type of Inspection Requested: is required
Signature of Applicant is required
Date is required