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 Meth Testing

Please put N/A for any fields that are not applicable
Inspection requested by:
Name
Address
Telephone Number
Email Address
Association to property:
Rush Sample results (2 day):
If you have additional documents to send, please email them to eh@tooeleco.gov.
Property to be tested:
Address
Owner
Owner's Phone Number
Owner's Address

Standard Sampling
First Test:   $150.00   Select:   Item Subtotal:  
$0.00
Each Additional Test:   $50.00   Quantity:   Item Subtotal:  
$0.00

Rush Sampling
Rush Sampling Test:   $185.00   Select:   Item Subtotal:  
$0.00
Additional Rush Sampling Tests:   $85.00   Quantity:   Item Subtotal:  
$0.00
Total:
$0.00
 
Applicant's E-Signature
Date

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Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
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Billing ZIP/Postal Code:
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