Tooele Health Department
             
Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435)277-2444
eh@tooelehealth.org
Recertification For Well / Septic


Please put N/A for any fields that are not applicable
For a well re-certification proof of water rights is needed.
For a septic re-certification evidence that the septic tank has been pumped within the last five years is needed

If you have additional documents to send, please email them to eh@tooelehealth.org.
Date
Home Owner's Name
Location of Home
Contact Phone Number
Contact Person if different than owner
Approval letter to go to the following:
Establishment Information
Organization Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
 
Septic Recertification:   $50.00   Select:   Item Subtotal:  
$0.00
Well Recertification/Bacterial Sample Only:   $125.00   Select:   Item Subtotal:  
$0.00
Well Recertification/Full Chemical Analysis:   $335.00   Select:   Item Subtotal:  
$0.00
Total:
$0.00
 

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Payment Information:
Method of Payment:
  Credit/Debit Card
  eCheck
 Update Name from Above
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
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