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 Operating Permit
Alternative Onsite Wastewater System
Applicants Name
Mailing Address
Site Address
Phone Number
Email Address
 
Type of System
Mounded (Packed Bed Media)
Single Pass Sand Filter
Recirculating Sand Filter
Recirculating Gravel Filter
Recirculating Textile Filter
Other
 

In consideration of the granting of said permit, I hereby specifically agree to each of the following conditions and specifically waive all objections thereto:

  1. Prior to operation of the alternative system, the premises shall be inspected by the Tooele County Health Department
  2. All business and premises operated pursuant to said permit will be conducted and maintained in accordance with all   relevant health statutes, ordinances, and regulations.
  3. During the term of said permit, Health Department inspectors will be granted access to the premises during normal working hours to conduct such inspections as may be necessary to guarantee compliance with health codes.
I understand and agree that violation of this application agreement may result in suspension, termination, or non-renewal of said permit.

 

This permit needs to be renewed annually.
 
Applicant's E-Signature
Date
 
Alternative Onsite Wastewater Operating Permit:   $50.00   Select:   Item Subtotal:  
$0.00
Total:
$0.00

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