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

Application For Food Handler Permit

Please put N/A for any fields that are not applicable
Applicant's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Date of Birth
Phone Number
Place of Employment
If you have additional documents to send, please email them to eh@tooeleco.gov.

I agree to abide by all local ordinances and laws of the State of Utah governing the service of food and beverage and I understand that failure to do so may result in revocation of my food service worker’s permit and/or other action as the law req

Signature of Applicant
Date

Food Handler Permit:   $20.00   Select:   Item Subtotal:  
$0.00
Food Handler Re-Issue (for lost permits):   $5.00   Select:   Item Subtotal:  
$0.00
Total:
$0.00
'Please Select Method of Payment to Continue'
First Name: is required
Last Name: is required
Address: is required
City: is required
State/Province: is required
ZIP/Postal Code: is required
Phone: is required
Email: is required
Date of Birth is required
Phone Number is required
Place of Employment is required
Signature of Applicant is required
Date is required