Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435)277-2444
Application for Well / Spring Water Permit
Please put N/A for any fields that are not applicable
Permit fee must be paid before permit will be issued.
Permit is only valid for 24 months from date of application.
Any changes must be approved in writing by TCHD.
Additional fees may be required for repeat samples, additional sampling parameter, or lab fee increases.
Click here to upload additional documents if needed.
Owner Phone Number
Site Address or Legal Description
Well Driller's Name
Individual Well Permit:
Chemical Analysis Water Sample Fee:
Rush Fee = Addition Fee of $130:
Method of Payment:
Update Name from Personal/Organizational Information
Name on Account:
Name on Card:
Billing Street Address:
Billing ZIP/Postal Code:
Change Payment Method
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