The Act for Promoting the Public Health

c. 123.

[Or that upon certain premises situate at, inserting such a 11 & 12 VICT. description as may be sufficient to identify the premises, Schedule (C.) there then was a foul and offensive drain, ditch, gutter, privy, cesspool, or ashpit, or a drain, &c., kept or constructed so as to be a nuisance to A. B. &c., as the case may be :

Or that upon certain premises, situate, &c., swine, or an accumulation of dung, manure, offal, filth, or refuse, or as the case may be, are or is kept so as to be injurious to the health of A. B., or of the occupiers of the premises adjoining the premises first aforesaid, or of persons living in the neighbourhood of the premises first aforesaid, or of persons living in the premises first aforesaid, or so as to be a nuisance to A. B., &c.:

And whereas the owner [or occupier] of the said dwelling house, [building or premises] having this day appeared before us, two of Her Majesty's justices of the peace acting in and for the county [or borough] of [or before me, one of the magistrates of the police courts of the metropolis, or, in Scotland, before the sheriff or magistrates or two justices of the peace, as the case may be], to answer the matter of the said complaint,—— [Or in case the party charged do not appear: And whereas it hath this day been proved to our or my satisfaction that a true copy of a summons requiring the owner or occupier of the said dwelling house or building or premises to appear this day before us or me has been duly served according to the statute in such case made and provided,-] And it having been proved [or also proved, as the case may require],

That the said dwelling house [or building] is in such a filthy and unwholesome condition as aforesaid,

[Or that upon the premises aforesaid [or first aforesaid] there
is a foul and offensive drain, privy, cesspool or ashpit, or
a drain, &c. kept or constructed so as to be a a nuisance to
A. B. &c., as the case may be,—

Or that upon the premises aforesaid, or first aforesaid, an
accumulation of dung, manure, offal, filth, or refuse, as
the case may be, is kept, or a pigsty exists, so as to be
injurious to health as aforesaid or so as to be a nuisance
to A. B. &c.; as the case may be] :-
We [or I] do hereby, in pursuance of the statute in such

APENDIX.

case made and provided, order the said owner [or occupier]
of the said dwelling house [or building, or premises, or first-
mentioned premises within
hours from the service of
this order [or a true copy thereof), according to the statute
in such case made and provided, to—

Cleanse [whitewash or purify] the said dwelling house;
[Or to cleanse, cover, or fill up, or as the case may require,
the said drain, ditch, gutter, privy, cesspool, or ashpit,
or otherwise as the case may require;

Or remove the said pigstye or accumulation of dung, offal,
filth, refuse, or matter, as the case may be, so that the same
shall not be injurious to health, or a nuisance, as aforesaid];
And if this order be not complied with, then we [or I]
authorize and require you the said town council [or guardians
of the poor, or, in Scotland, the procurator fiscal of the
county of
or the procurator fiscal or dean of guild
or the procurator of the justices of the
or the inspector of the poor of

of the burgh of
peace of the county of
the parish of — as the case may be] to enter upon the
said dwelling house, [or building, or premises, or first men-
tioned premises,] and to do all such works, matters, and things
as may be necessary for carrying this order into effect, ac-
cording to the statute in such case made and provided.

And for your so doing this shall be your sufficient warrant. Given under our hands and seals [or, my hand and seal, or, in Scotland, our hands, or my hand], this

one thousand eight hundred and

day of

County of
[or Borough,
Burgh..
....or Metro-
politan Police District,
or as the case may be]
to wit.

WHEREAS complaint hath been made to me, E.F., esquire, one of Her Majesty's justices of the peace in and for the county [or borough, &c.] of [or one of the magistrates of metropolis, or as the case may be, or in Scotland, to me, G. H., sheriff, or one of Her Majesty's justices of the peace, as the case may be, of the county of

the police courts of the

-], by A.B., owner within the meaning of the "Nuisances Removal and Diseases Prevention Act, 1848," of certain premises, to wit, a dwelling house [or building, or as the case may be], situate [insert such a description of the premises as may be sufficient to identify them], in the parish of in the said county [or borough, &c.], that C. D., the occupier of the said premises, doth prevent the said A. B. from obeying and carrying into effect the provisions of the said Act, in this, to wit, that he the said C. D. doth prevent the said A. B. from

[Here describe the works generally according to the circumstances; for instance, thus: cleansing or whitewashing or purifying the said dwelling house, or building, or cleansing a foul and offensive drain, ditch, gutter, privy, cesspool, or ashpit, which exists upon the said premises, or as the case may require] :

And whereas the said C. D. having been summoned to answer the said complaint, and not having shown sufficient cause against the same, and it appearing to me that the said works are necessary for the purpose of enabling the said A.B. to obey and carry into effect the provisions of the said Act, I do hereby order that the said C. D. do permit the said A. B. to execute the same in the manner required by the said Act.

Given under my hand and seal [or, in Scotland, under my hand] this day of in the year of our Lord one

thousand eight hundred and

* [In Scotland without Seal].

E. F. (L.S.)*

11 & 12 VICT.

c. 123.

ADDITIONAL FORMS.

Petition for Application of the Public Health Act, 1848.

Whereas by the Public Health Act, 1848, it is enacted, that from time to time after the passing of that Act upon the petition of not less than one-tenth of the inhabitants, rated to the relief of the poor of any city, town, borough, parish or

ADDITIONAL
FORMS.

APPENDIX. place, having a known or defined boundary, not being less than thirty in the whole, the general board of health may, if and when they shall think fit, direct a superintending inspector to visit such city, town, borough, parish or place, and to make public inquiry, and examine witnesses as to the sewerage, drainage, and supply of water, the state of the burial grounds, the number and sanitary condition of the inhabitants, and as to any local Acts of parliament in force within such city, town, borough, parish or place, for paving, lighting, cleansing, watching, regulating, supplying with water, or improving the same, or having relation to the purposes of the said Act; also as to the natural drainage areas, and the existing municipal, parochial, or other local boundaries, and the boundaries which may be most advantageously adopted for the purposes of the said Act, and as to any other matters in respect whereof the said board may desire to be informed for the purpose of enabling them to judge of the propriety of reporting to Her Majesty or making a provisional order as mentioned in the said Act:

Now, therefore, we the undersigned inhabitants of the [city, or town, or borough, or parish, as the case may be,] of –

in the county
of -[or where the petition proceeds
from a place not being a city, town, borough, or parish, insert
instead of the words following the word "therefore,” these
words, we the undersigned inhabitants of -
- in the county
of
(the same being a place having a known or defined
boundary within the meaning of the said Act)] and rated to the
relief of the poor in respect of property within that [city, or
town, or borough, or parish, or place, as the case may be], and
being one-tenth in number of the inhabitants rated to the relief
of the poor in respect of property within the same [city, or
town, or borough, or parish, or place, as the case may be],—
do hereby petition the general board of health to direct a super-
intending inspector to visit the said [city, or town, or borough,
or parish, as the case may be], and to make inquiry and
examination with respect thereto with a view to the application
of the said Act according to the provisions thereof in that
behalf.

[Here insert the christian name and surname of the
petitioners in full, and their residence in the city,
town, borough, parish or place from which the petition
proceeds.

IN SCOTLAND.

IN IRELAND.

IN ENGLAND OR IRELAND.

To the

Town council of the borough of

: (g)

ADDITIONAL
FORMS.

Trustees (or commissioners) for the drainage (or paving or lighting, or cleansing) of the city (or town, or borough,

or parish) of

the county of

(or of
: (g)