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@TooeleCo.gov
Application For Decontamination of Chemically Contaminated Property Permit

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

Decontamination Company:
Name
DEQ Certification Number
Address
Telephone Number
Email Address
If you have additional documents to send, please email them to eh@tooeleco.gov.

Property to be decontaminated:
Address
Owner
Owner's Phone Number
Owner's Address

Permit Fee:   $350.00   Item Subtotal:  
$350.00
Total:
$350.00
 
Applicant's E-Signature
Date
'Please Select Method of Payment to Continue'
Payment Information:
Method of Payment:
  Credit/Debit Card
  eCheck
 Update Name from Above
Name is required
DEQ Certification Number is required
Address is required
Telephone Number is required
Email Address is required
Address is required
Owner is required
Owner's Phone Number is required
Owner's Address is required
Applicant's E-Signature is required
Date is required
You must enter a payment method.