Provide Name of Establishment, Address of Establishment and MCESD Permit Number.
Please be aware that the file must be in PDF format. Total file size is limited to 250 MB. Upload any additional files below.
Please check all of the policies that apply to your facility.
All policies checked above include a policy that addresses minimum code requirements for all of the applicable areas, a training component on the policies, and a verification component. All of the submitted policies are valid at the time of submittal and agree to maintain copies of these policies on hand for review during inspections.
Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
This field is not part of the form submission.
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