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 Safety Manager Certification

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Applicant Information
First Name: Last Name:
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Place of Employment
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I agree to abide by all local ordinances and laws of the State of Utah governing the service of food and beverageand I understand that failure to do so may result in revocation of my Food Safety Manager Certification.

Name of Food Service Manager Exam
Date of Exam

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