San Juan County Public Health
             
San Juan County Health Department
735 S 200 W Suite 2, Blanding, UT 84511
Phone: (435) 587-3838

Tanning Establishment
NOTE: Our Environmental Health Director will contact you about your application. If you have any questions please contact Ronnie Nieves at (435) 587-3838 Ext: 3505


Establishment Information
Organization Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

Contact Name
Contact Phone Number
Number of Tanning Beds
 
Applicant agrees that maintenance of a health permit is predicated on compliance with Utah State Rule R392-700, Indoor Tanning Bed Sanitation. This permit is revocable for noncompliance. Permit is valid for one year from the date issued.
Signature of Applicant
Title
Date

Tanning Establishment Permit Fee:   $100.00   Item Subtotal:  
$100.00
Total:
$100.00
 
Payment Information:
Processing Fee Rates:
Cards:2.5% ($1.50 min)
(1.5% surcharge for foreign cards)
eCheck:$0.75
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
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