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
Application For Waste Transporter Permit

Please put N/A for any fields that are not applicable

Name of Company
Contact Person
Phone Number
Location
Email Address
Mailing Address

Permit:   $50.00   Quantity:   Item Subtotal:  
$0.00
Vehicle License Number [1]
Unit Number [1]
Model [1]
Make [1]
Year [1]
Body Capacity [1]
County Vehicle Registered In [1]
Facility Waste To Be Delivered To [1]
Type of Waste To Be Transported [1]

Vehicle License Number

[2]
Unit Number [2]
Model [2]
Make [2]
Year [2]
Body Capacity [2]
County Vehicle Registered In [2]
Facility Waste To Be Delivered To [2]
Type of Waste To Be Transported [2]

Vehicle License Number

[3]
Unit Number [3]
Model [3]
Make [3]
Year [3]
Body Capacity [3]
County Vehicle Registered In [3]
Facility Waste To Be Delivered To [3]
Type of Waste To Be Transported [3]

Vehicle License Number

[4]
Unit Number [4]
Model [4]
Make [4]
Year [4]
Body Capacity [4]
County Vehicle Registered In [4]
Facility Waste To Be Delivered To [4]
Type of Waste To Be Transported [4]

Vehicle License Number

[5]
Unit Number [5]
Model [5]
Make [5]
Year [5]
Body Capacity [5]
County Vehicle Registered In [5]
Facility Waste To Be Delivered To [5]
Type of Waste To Be Transported [5]

Vehicle License Number

[6]
Unit Number [6]
Model [6]
Make [6]
Year [6]
Body Capacity [6]
County Vehicle Registered In [6]
Facility Waste To Be Delivered To [6]
Type of Waste To Be Transported [6]

Vehicle License Number

[7]
Unit Number [7]
Model [7]
Make [7]
Year [7]
Body Capacity [7]
County Vehicle Registered In [7]
Facility Waste To Be Delivered To [7]
Type of Waste To Be Transported [7]

Vehicle License Number

[8]
Unit Number [8]
Model [8]
Make [8]
Year [8]
Body Capacity [8]
County Vehicle Registered In [8]
Facility Waste To Be Delivered To [8]
Type of Waste To Be Transported [8]

Vehicle License Number

[9]
Unit Number [9]
Model [9]
Make [9]
Year [9]
Body Capacity [9]
County Vehicle Registered In [9]
Facility Waste To Be Delivered To [9]
Type of Waste To Be Transported [9]

Vehicle License Number

[10]
Unit Number [10]
Model [10]
Make [10]
Year [10]
Body Capacity [10]
County Vehicle Registered In [10]
Facility Waste To Be Delivered To [10]
Type of Waste To Be Transported [10]

Vehicle License Number

[11]
Unit Number [11]
Model [11]
Make [11]
Year [11]
Body Capacity [11]
County Vehicle Registered In [11]
Facility Waste To Be Delivered To [11]
Type of Waste To Be Transported [11]

Vehicle License Number

[12]
Unit Number [12]
Model [12]
Make [12]
Year [12]
Body Capacity [12]
County Vehicle Registered In [12]
Facility Waste To Be Delivered To [12]
Type of Waste To Be Transported [12]

Vehicle License Number

[13]
Unit Number [13]
Model [13]
Make [13]
Year [13]
Body Capacity [13]
County Vehicle Registered In [13]
Facility Waste To Be Delivered To [13]
Type of Waste To Be Transported [13]

Vehicle License Number

[14]
Unit Number [14]
Model [14]
Make [14]
Year [14]
Body Capacity [14]
County Vehicle Registered In [14]
Facility Waste To Be Delivered To [14]
Type of Waste To Be Transported [14]

Vehicle License Number

[15]
Unit Number [15]
Model [15]
Make [15]
Year [15]
Body Capacity [15]
County Vehicle Registered In [15]
Facility Waste To Be Delivered To [15]
Type of Waste To Be Transported [15]

Vehicle License Number

[16]
Unit Number [16]
Model [16]
Make [16]
Year [16]
Body Capacity [16]
County Vehicle Registered In [16]
Facility Waste To Be Delivered To [16]
Type of Waste To Be Transported [16]

Vehicle License Number

[17]
Unit Number [17]
Model [17]
Make [17]
Year [17]
Body Capacity [17]
County Vehicle Registered In [17]
Facility Waste To Be Delivered To [17]
Type of Waste To Be Transported [17]

Vehicle License Number

[18]
Unit Number [18]
Model [18]
Make [18]
Year [18]
Body Capacity [18]
County Vehicle Registered In [18]
Facility Waste To Be Delivered To [18]
Type of Waste To Be Transported [18]

Vehicle License Number

[19]
Unit Number [19]
Model [19]
Make [19]
Year [19]
Body Capacity [19]
County Vehicle Registered In [19]
Facility Waste To Be Delivered To [19]
Type of Waste To Be Transported [19]

Vehicle License Number

[20]
Unit Number [20]
Model [20]
Make [20]
Year [20]
Body Capacity [20]
County Vehicle Registered In [20]
Facility Waste To Be Delivered To [20]
Type of Waste To Be Transported [20]
Total:
$0.00

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