Required fields are marked with asterisks (*)

Notification of Intent to Operate New Seasonal Housing for International Agricultural Workers

Every owner/operator who intends to provide seasonal housing for migrant farm workers for the first time shall notify Durham Region Health Department in writing of their intent.

Complete the application form and submit to Durham Region Health Department no later than 6 weeks prior to the arrival of the migrant farm workers.
Contact Durham Region Health Department to arrange for an inspection at least 14 days prior to migrant farm workers arriving.

Note: Please ensure that all housing requirements have been met prior to inspection, otherwise the seasonal housing accommodation will not be approved.

Owner/operator providing seasonal housing

First name

Last name

Phone number

Street address

City/Town

Postal code

Email address

Bunkhouse details

Name of bunkhouse

Street address

City/Town

Postal code

Proposed maximum occupancy

Expected date of workers arrival

Water supply information:

Type of water supply provided for workers

Municipal supply

Commercially bottled

Hauled municipal water

Well

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I certify that the above information is complete and correct and that the seasonal housing facilities will be operated in compliance with the Recommendations for the Provision of Seasonal Housing for Migrant Farm Workers

I confirm

Owner/operator signature

Clear

Collection of information on this form is under the authority of the Health Protection and Promotion Act, R.S.O. 1990 c.H.7, s.5. This information is collected and used for the purpose of assessment and inspection of facilities, identification, investigation, and management of adverse health outcomes arising from health hazards and/or infectious diseases in the environment. Information may be disclosed to external institutions and agencies for investigations, inspections that lead or could lead to proceedings, legal and/or regulatory requirements or as required by law. Questions about this collection of information should be addresses to the Manager, Health Information, Privacy and Security, Durham Region Health Department, at 605 Rossland Rd E, P.O. Box 730, Whitby, ON L1N 0B2, 905-668-7711.