FOGS ONLINE SUBMISSION FORM

Contact Person

Company name

Phone

Email

Address

______________________________________

Please Describe your food preparation and cleanup activites:

2. Approximately how many customers do you serve per average day? (This info will be kept confidential)

How are the following food by-products disposed of? (Check all that apply)

Solid Wastes:

Sewer

Trash

Professional Disposal

N/A

Oil & Grease:

Sewer

Trash

Professional Disposal

N/A

Liquid Wastes:

Sewer

Trash

Professional Disposal

N/A

Do you have a grease interceptor or trap?

(A grease interceptor is a large underground device designed to remove fat, oil, and grease from your kitchen wastewater. A grease trap is a small, similar device that is located under the sink. Theses are both different from your Grease Recyling Bin.)

Grease interceptor or track (select one)

Yes

No

______________________________________

If you selected NO, please skip the next section and click Submit.

If you selected YES, please continue the questionaire

6. What size (gallons) is the interceptor?

7. Is the interceptor functioning properly? Type either Yes or No (if NO, please explain)

8. How often is the interceptor serviced?

9. When was the interceptor serviced?

10. What is the average volume of waste which is removed from the interceptor when it is serviced?

11. What is the name and address of the business that services the interceptor?

12. Are the service receipts available?

Yes

No

13. Which of the following kitchen fixtures are connected to your grease interceptor? (please indicate amount of those that apply)

Any additional comments:

______________________________________

By checking this box, I submit that the information in this questionnaire is familiar to me and, to the best of my knowledge and belief is true, complete, and accurate.

Date picker

Form Page

FOGS ONLINE SUBMISSION FORM

______________________________________

______________________________________

If you selected NO, please skip the next section and click Submit.

If you selected YES, please continue the questionaire

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