DRAFT - Indoor Tanning Bed Facility Plan Review

Indoor Tanning Bed Facility Plan Review
For more information, please refer to Utah Rule: R392-700

Inspection Checklist for Indoor Tanning Bed Facilities
Date

MonthDayYear
Date
Contact Person

First NameLast Name
Contact Person's Phone Number
Please enter a valid phone number.
Facility Name:*
Facility Address (physical and mailing)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Facility Phone Number*
Please enter a valid phone number.
Facility Email
example@example.com

Fee

Plan Review Fee

$350.00 Quantity

Total

$0.00