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 Mass Gathering Permit

"Temporary mass gathering" or "Gathering" means an actual or reasonably anticipated assembly of 1,000 or more people, which continues or can reasonably be expected to continue for two or more hours a day, at a site or sites for a purpose different from the designed use and usual type of occupancy."

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


Mass Gathering Plan Review Amount:   $50.00   Item Subtotal:  
$50.00
 
Permits
 
Permit (1,000-1,999 people staying 2+ hours)/day:   $100.00   Quantity:   Item Subtotal:  
$0.00
Permit (2,000+people staying 2+ hours)/day:   $200.00   Quantity:   Item Subtotal:  
$0.00
Total:
$50.00
 
Event Coordinator's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

Event Name
Location of Gathering
Dates & Times of Gathering
Purpose of Gathering
Number of People Expected to Attend
Peak Number of People Expected
Estimated Length of Stay of Attendees
Name of Property Owner
Address of Property Owner
Phone Number of Property Owner
Site Clean Up Plan
Plan for Directional and Exit Signs
Plan to address nuisances or health hazards associated with animals present at the gathering:
Plan to address hazardous conditions
*Plan to address hazardous conditions, including but not limited to evacuation, cancellation or delay of the gathering and provisions for support facilities
Number of Food Vendors Expected
Have you notified Food Vendors of required permits
Yes
No
Name of Solid Waste Haulers
Phone #
Name of Liquid Waste Haulers
Phone #
Total Number of Emergency Medical Personnel & Qualifications

* Submit a site plan delineating the area where the gathering is to be held, including the following:
1. The parking area available for patrons;
2. Location of entrance, exit, and interior roadways and walks;
3. Location of all first aid stations and emergency medical resources;
4. Location, type and provider of restroom facilities;
5. Location and description of water stations;
6. Location and number of food stands, and the types of food to be served if known; (separate food booth permits are required for each vendor)
7. Location, number, type and provider of solid waste containers;
8. Location of operators headquarters at the gathering;
9. Location plan to provide adequate lighting to ensure the comfort and safety of attendees and staff;
10. Location of all parking areas designated for the gathering and under the operators control;
11. Provisions for allowing health inspectors onsite

Please send your site plan with the above information to EH@TooeleCo.Gov
Signature of Applicant
Date

'Please Select Method of Payment to Continue'

Payment Information:
Method of Payment:
  Credit/Debit Card
  eCheck
 Update Name from Above
 

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
Event Name is required
Location of Gathering is required
Dates & Times of Gathering is required
Purpose of Gathering is required
Number of People Expected to Attend is required
Peak Number of People Expected is required
Estimated Length of Stay of Attendees is required
Name of Property Owner is required
Address of Property Owner is required
Phone Number of Property Owner is required
Site Clean Up Plan is required
Plan for Directional and Exit Signs is required
Plan to address nuisances or health hazards associated with animals present at the gathering: is required
Plan to address hazardous conditions is required
Number of Food Vendors Expected is required
Name of Solid Waste Haulers is required
Phone # is required
Name of Liquid Waste Haulers is required
Phone # is required
Total Number of Emergency Medical Personnel & Qualifications is required
Signature of Applicant is required
Date is required
You must enter a payment method.