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
County Vehicle Registered In
Type of Waste To Be Transported

Permit:   $50.00   Quantity:   Item Subtotal:  
$0.00
Total:
$0.00
Vehicle License Number
Unit Number
Model
Make
Year
Body Capacity
Facility Waste To Be Delivered To

“If permitting multiple units please attach a spreadsheet outlining the license plate, unit number, model, make, year, and capacity of each truck”


Applicant's E-Signature
Date
 
 
Payment Information:
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method
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