Learn more about San Mateo County Health.
The Health Executive Council includes San Mateo County Health’s chief, deputy chief, health officer and other division and team leaders.
Stay informed on upcoming events from San Mateo County Health.
Learn how San Mateo County Health’s Health Coverage Unit can help you apply for Medi-Cal, get enrollment assistance and find low-cost health care options.
Find key phone numbers, department contacts and media inquiries at San Mateo County Health.
Find health services, programs and resources we offer. Get connected to care, support and information that can help you and your family stay healthy.
Through our divisions’ work, we protect San Mateo County by reducing environmental health risks, preventing disease, and promoting the physical and mental well-being of our entire community.
Protection, support and advocacy for older adults and persons with disabilities.
Regulatory oversight of public and private emergency medical services.
Protects the health of everyone in San Mateo County.
Provides mental health and substance use services.
Environmental Health Services is the local authority on environmental health and safety policy and enforcement.
Provides integrated medical, dental, mental health and chemical dependency treatment to the incarcerated adult population.
Focuses on early intervention with San Mateo County parents and children who are low-income and have faced health inequities
Learn more about Health Officer and her work in San Mateo County
Provides accessible, high-quality care with a focus on prevention and community partnership.
We are a public hospital and clinic system that serves all San Mateo County residents by providing accessible, high-quality care with a focus on prevention and community partnership.
Get more information about how to create or log in to your MyChart.
We offer comprehensive preventative care, diagnostics and treatment for adults.
We provide comprehensive care for women's reproductive, hormonal and general health across all life stages.
We have expertise in specialized medical care.
We provide care for teeth and gum conditions.
We provide other services including rehabilitation, lab, imaging and therapy.
Available 24/7, we provide Immediate medical care for urgent, life-threatening conditions and injuries.
We provide full hospital care and comfort, including pain and symptom relief for serious illnesses.
San Mateo County Health partners with community members through boards, commissions and initiatives that guide programs, shape policies and promote equity
Environmental Health Services
In San Mateo County, the only approved system is a septic system. In a septic system, wastewater goes into a large underground tank. Pumping removes the solids in the tank. The liquid in the tank flows into the ground through a system of underground pipes and gravel. Over time, as the liquid soaks into the ground, organisms that live in the ground and in the sewage eat the organic materials and the harmful bacteria die.
Inspection staff will observe and approve the work when you need to install, repair, alter or destroy an individual sewage disposal system. They do this by:
When a septic system fails, sewage may back up into a home or it may pool onto the ground. Inspection staff investigate complaints of failed septic systems to make sure there is no hazard to public health.
All people who install individual water supplies or sewage disposal systems must have a permit from Environmental Health. Submit your Septic Application through the MyEHS Portal. You can also pay your application fee online through the portal.
Payments cannot be made to or accepted by inspectors. Payments must be made in person at the Environmental Health Services office, by mail, by phone at (650) 372-6200, or online through the MyEHS Portal.
If you’re unable to apply online with MyEHS, you can download and complete the Septic Application PDF application here (see Downloadable Applications Forms Section).
Application approval can take some time. Inspection staff check permit applications to make sure that all installations will be safe for neighboring properties and surrounding areas. Often, community members and/or the County Board of Supervisors must approve the installation of new systems, as well.
The current Onsite Wastewater Treatment System (OWTS) Ordinance was approved by the County Board of Supervisors and was effective on February 4, 2016. Our Onsite Systems Manual (OSM) (May 11, 2016) is the implementation manual for the new OWTS Ordinance. The Ordinance and OSM are designed to comply with the recent State OWTS Policy.
San Mateo County’s Local Agency Management Program (LAMP) pertains to the oversight of onsite wastewater treatment systems (OWTS) within the County of San Mateo, California. The LAMP was prepared in accordance with the requirements of the State Water Resources Control Board’s (SWRCB) Water Quality Control Policy for Siting, Design, Operation and Maintenance of Onsite Wastewater Treatment Systems, dated June 19, 2012, also referred to as the “OWTS Policy,” and submitted to the Regional Water Quality Control Board, San Francisco Region, on May 11, 2016. The LAMP was prepared by San Mateo County to obtain approval for OWTS management under Tier 2 of the OWTS Policy. As such, it is intended to allow the County to continue providing local oversight of OWTS by implementing practices that: (a) are suited to the conditions in San Mateo County; (b) meet or exceed the environmental protections of the “default” siting and design requirements for OWTS identified in Tier 1 of the SWRCB OWTS Policy; and (c) ensure the best opportunity for coordinated and comprehensive management of OWTS, public health and water quality in San Mateo County.
The complete Onsite Systems Manual and manual by sections can be found in the Resource Library.
Effective October 2025, the Onsite Systems Manual (Updated Oct 2025) now incorporates farm labor housing onsite wastewater treatment system guidelines. Refer to pages 10-11.
Timeline September 8, 2025 – presented at the Agriculture Advisory Committee Meeting October 14, 2025 – presented at the Pescadero Advisory Committee Meeting October 20, 2025 – presented again at the Agriculture Advisory Committee Meeting September 18, 2025 – San Francisco Regional Water Quality Control Board Approval