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 Massage Establishment Plan Review


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

Owner's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

Establishment Name
Phone Number
Street Address
Mailing Address

PLAN REVIEW CHECKLIST

  • Scale drawing of floor plan, Sec. 7.3
  • Plan review fee, Sec 6.3
  • The hours of operation of the establishment or outcall massage service, Sec 7.4
  • The number of employees, Sec 7.5
  • The equipment, instruments, and materials to be used, Sec 7.6
  • The methods of sterilizing or disinfecting equipment and instuments, Sec 7.7
  • Storage area for instruments and supplies

All of the above statements are true. I understand that any false information on this application may be cause for denial or revocation of my Massage Establishment Health Permit. Permits may be revoked or suspended for violations of Tooele County Health Department Regulation #6. Permits are non-transferable.

Message Estblishment Plan Review:   $50.00   Item Subtotal:  
$50.00
Total:
$50.00
Payment Information:
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method
Submitting ...
SIP Program & Data © 2006-2020 Instant Payments All rights reserved.
~ Terms & Conditions ~ Privacy Policy ~ Contact Us ~
SIP Version 3.05.13176; (API: 2.17)
RSI Security PCI DSS Compliance Instant Payments BBB Business Review