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Tuesday, February 09, 2010
   
ENVIRONMENTAL ABATEMENT & LICENSING SYSTEM (EALS) REQUEST

The below information is required to obtain secure access to EALS. By submitting this request, you swear or affirm that you are authorized to perform business processes related to the ODH licensed professional below.
     
    Reminder regarding requests
    Only one account will be authorized per licensed professional or company.
     
  1. Please check at least one box:*

  2. Technical Issue Description:

    3.  
    LICENSE INFORMATION
     
  3. Please check at least one box:*

  4. License Name or Entity:*

  5. ODH License Number:*

    6.  
    AUTHORIZED CONTACT INFORMATION
     
  6. First Name:*

  7. Last Name:*

  8. Title:*

  9. E-mail Address:*

  10. Secondary Contact Name:*

    11.  
    ODH CONTACT INFORMATION
    If you have a question regarding use of this form e-mail us at liccert@odh.ohio.gov.
     
 

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