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Request for a Replacement Sanitation Grade Card (H-3068)

I am requesting a replacement for the Sanitation Grade Card that was issued to this establishment.

indicates a required field.

Name of Establishment/OBA

Establishment Address

City

State

Zip Code

Requester’s Name (Please Print)

Job Title

Reason for request:

Grade Card Lost

Grade Card Damaged (you must turn in damaged card to get a new one)

Other

Other (please explain)

Requester’s Signature

Date (Enter date as MM/DD/YYYY)

Submit your request in person:

Frank P. Zeidler Municipal Building
841 North Broadway, 3rd Floor
Milwaukee, WI 53202
8:AM to 4:30PM

Mail-in requests are not accepted.