Mobile Unit: Wastewater Disposal Form (Portland, Oregon)

This is the official Mobile Unit: Wastewater Disposal Form from Multnomah County Environmental Health Services. You can fill it in its original layout in your browser or with an AI assistant, then download it to review, sign and submit to the agency.

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Form details

Issuer: Multnomah County Environmental Health Services
Jurisdiction: Portland, Oregon
Type: Food truck and mobile vending permits
Questions: 47
Last mapping review: 2026-10-02

Official blank PDF from Multnomah County Environmental Health Services ↗

What this form asks

Mobile Food Unit Name
Facility #
Mobile Location (Street Address, City)
Phone #
Name of Mobile Food Unit Owner (Print)
Date Signed (date)
Operating Hours: Sun From
Months of Operation: All Year (checkbox)
Months of Operation: Mar (checkbox)
Months of Operation: Apr (checkbox)
Months of Operation: May (checkbox)
Months of Operation: Jun (checkbox)
Months of Operation: Jul (checkbox)
Months of Operation: Aug (checkbox)
Months of Operation: Sept (checkbox)
Months of Operation: Oct (checkbox)
Months of Operation: Nov (checkbox)
Months of Operation: Dec (checkbox)
Disposal Method 1: Onsite Disposal (checkbox)
Onsite Disposal: Business or POD Name
Onsite Disposal: Phone #
Onsite Disposal: Address
Onsite Disposal: City
Onsite Disposal: County
Disposal Method 2: Wastewater Hauler (checkbox)
Disposal Method 3: Self Hauling (checkbox)
Self Hauling: a. By driving your food truck to an approved disposal location (checkbox)
Name of Disposal Area
Name of Licensed Wastewater Hauler
Wastewater Hauler: Phone #
Operating Hours: Sun To
Operating Hours: Mon From
Operating Hours: Mon To
Operating Hours: Tue From
Operating Hours: Tue To
Operating Hours: Wed From
Operating Hours: Wed To
Operating Hours: Thur From
Operating Hours: Thur To
Operating Hours: Fri From
Operating Hours: Fri To
Operating Hours: Sat From
Operating Hours: Sat To
Months of Operation: Jan (checkbox)
Months of Operation: Feb (checkbox)
Self Hauling: b. By hand-carrying wastewater in an approved tote no larger than 20 gallons to an approved wastewater disposal location (checkbox)
Wastewater Hauler: DEQ # (required)

Review, sign and submit

PaperPorter fills the form but does not submit it or approve anything. Signatures, initials and staff-only areas are left for the right person. Confirm current fees, attachments and filing instructions with Multnomah County Environmental Health Services.

Other Portland forms

Mobile Unit: Restroom Agreement Form Multnomah County Environmental Health Services
Application for Sidewalk Vending Cart Permit Portland Bureau of Transportation
Warehouse Operating License Application Multnomah County Environmental Health Services
Business Registration Form (Form REG): City of Portland Business License Tax, Multnomah County Business Income Tax, Metro SHS Business Income Tax City of Portland Revenue Division
Mobile Food Unit Plan Review Application Packet Multnomah County Environmental Health Services
Mobile Unit Commissary Use Verification Form Multnomah County Environmental Health Services
Mobile Food Unit Operating License Application Multnomah County Environmental Health Services

Food truck and mobile vending permits in other places

Frequently asked questions

Does PaperPorter submit this form?

No. You download the completed PDF, then review, sign and submit it to Multnomah County Environmental Health Services yourself.

Can I fill it without an AI assistant?

Yes. Fill it in your browser and download the completed PDF. An assistant such as ChatGPT or Claude can also ask you the questions and fill it for you.