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Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435) 277-2444
www.tooelehealth.org
eh@TooeleCo.gov
Application For Solid Waste Management Facility
Permit and Application Fee
Facility Name
Facility Phone
Facility Address
Mailing Address
Owner Name
Owner Phone #
Owner Mailing Address
Owner Email Address
Infectious Waste Storage Facility(annually):
$100.00
Select:
Item Subtotal:
$0.00
Private/Industrial Landfill or Processing Facilty
Private/Industrial/Processing 0-200 tons/day:
$300.00
Select:
Item Subtotal:
$0.00
Private/Industrial/Processing 201-700 tons/day:
$400.00
Select:
Item Subtotal:
$0.00
Private/Industrial/Processing over 700 tons/day:
$500.00
Select:
Item Subtotal:
$0.00
Applicant's E-Signature
Date
Total:
$0.00
Payment Information:
Method of Payment:
Credit/Debit Card
Update Name from Above
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
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