Environmental Health

1203 Maple Street, Greensboro 27405

(336) 641-3771

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Supporting documentation must be attached in

PDF format only

to submit application. If you have more than one pump, please print a blank page 2 of the application and add it as an attachment.

Document may be downloaded, saved, and/or printed after acknowledgment.

Incomplete applications will not be accepted.

Please check that you agree before continuing.

By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.

Additional Signatures Required

Upload Attachment(s)

Please upload the following required attachments in PDF format only:

There is a 250MB limit on each attachment.

Pump Specifications w/Curve Click Here to Upload

Drain Cover Specifications Click Here to Upload

Skimmer Equalizer Fittings Specifications Click Here to Upload

Engineer's Certification (if flow of pump has been reduced) Click Here to Upload

Additional Pumps (page 2) Click Here to Upload

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