Tooele Health Department
             
Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435)277-2444
Tanning Facility Permit Application

Please put N/A for any fields that are not applicable
Establishment Information
Organization Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Contact Name
Number of Tanning Beds
Applicant agrees that maintenance of a health permit is predicated on compliance with Utah State Rule R392-700, Indoor Tanning Bed Sanitation. This permit is revocable for noncompliance. Permit is valid for one year from the date issued. A copy of the business license is required. 
Signature of Applicant
Title
Date
Tanning Establishment Permit:   $100.00   Item Subtotal:  
$100.00
(Including up to 4 beds)
Each additional bed:   $10.00   Quantity:   Item Subtotal:  
$0.00
Total:
$100.00

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Method of Payment:
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Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
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