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2. FSE GCD Registration and FOG Approval Request
   
6. ATTENTION:

   If INSTALLING OR RETRO-FITTING a new grease control device (grease trap or grease interceptor) or if BUILDING OR PLUMBING PERMITS are required, please visit the following link to complete Appendix A of the: FOG Approval Request

   
   

   All other Food Services Establishments must complete the online registration below for review, in order to receive FOG Approval.

   
   

   All FSEs that have submitted the FOG Approval Request and have been issued a FOG Approval Letter, must complete the FSE GCD Registration when "setting up their water and sewer service or prior to obtaining a certificate of occupancy" per Chapter 39.1, Article V, Sec. 39.1-33(b).

8. Enter the Food Service Establishment (FSE) Information
10. Select All That Apply:*

    1. New Business
    2. New Buildout
    3. Shell Buildout (tenant unknown)
    4. Renovation/Addition
    5. Relocating Business
    6. Change of Ownership

    1. Building Permit
    2. Plumbing Permit
    3. Commissary
    4. Mobile Vendor/Food Truck
    5. Ghost Kitchen

    1. Pop-Up Kitchen
    2. Temporary Event Operator
    3. Farmers Market
    4. Food Manufacturer
    5. Other:
12. Other:
14. FSE Name:*
15. Physical Street Address:*
16. Zip Code:*
18. Legal Business Name (DBA):*
19. Phone:*
20. Email:
22. Menu Type:*
    -- Select One --BakeryBar and GrillBarbeque Breakfast Bar/HotelBuffetBurger and Fries, Fast FoodCafeteriaCatererChineseCoffee ShopConvenience StoreDeep Fried Chicken/Seafood DeliFamily Restaurant Frozen YogurtGreekGrocery BakeryGrocery DeliGrocery Meat DepartmentIce CreamIndianItalianMexican, Fast FoodMexican, Full FarePizzaReligious InstitutionSandwich ShopSnack BarSteak and SeafoodSushiOther
23. Other:
25. Upload Menu 1:
26. Upload Menu 2:
27. Upload Menu 3:
29. Estimated number of meals sold per day:*
30. Do you have a fryer? *
    -- Select One --YesNo
31. Do you wash forks, knives & spoons?*
    -- Select One --YesNo
32. Do customers use plastic utensils?*
    -- Select One --YesNo
34. Are there 2 or more food service businesses using the commercial kitchen space/waste services?

    1. Yes
    2. No

    If Yes, please refer each food service business to this registration form with the City of Norfolk FOG Program.

35. Upload List of Food Service Businesses using commercial kitchen/waste services:

    Only upload list of food businesses if you are the owner or operator of a commissary kitchen leasing the use of a commercial food space or providing food waste or grey water disposal to food service businesses, that do not have a brick & mortar establishment.

39. Person in Charge:*
40. Phone:*
42. Contact Title/Role:*
43. Additional Contact:
45. Owner/Co. Name:
46. Owner/Co. Phone:
48. Owner's Address 1:
49. Address 2:
51. City:
52. State:
53. Zip:
57. The Hampton Roads Fats, Oils & Grease Best Management Practices Certification is required for all food service establishments (this includes mobile food trucks or food services leasing commercial kitchen space or waste disposal services):
59. HR FOG Best Management Practices (BMP) Certified?*

    1. Yes
    2. No

    If No, please visit the following link to complete the Online Free FOG Training: www.hrfog.com

60. HR FOG Certified Employee:
61. Upload HR FOG BMP Certification Card:
65. Attention (ONLY FOR MOBILE/TEMPORARY FOOD VENDORS):

    Mobile Vendors / Food Trucks / Pop-Ups / Ghost Kitchens / Food Manufacturers or any food service business leasing a commercial kitchen space, please complete the following section, then sign and submit GCD Registration Form.

    Please provide photos of waste disposal locations as requested below, as they apply to your food service:

67. If you are a mobile food service or food truck, where do you dispose of grey water?
68. Upload Commissary Letter:

    Mobile vendors, food trucks, temporary event operators, food manufacturers or any food service businesses using a commercial kitchen for food processing and food waste disposal services in the City of Norfolk, must provide proof of permission to use said facilities.

70. # of GCD(s):

    Grease Control Device used by commercial kitchens to capture oil, grease and food debris from entering the sanitary sewer system.

71. # of Solid Interceptors:

    Not common and typically found prior to a grease control device to capture large quantities of food or other debris.

72. # of Greywater Tanks

    Used for the disposal/storage of food wastewater from equipment in mobile food trucks or at temporary events, such as 3 compartment sink water (used for food prep and washing/rinsing/sanitizing of food contact surfaces, handing washing sinks, etc...).

73. # of Used Cooking Oil Containers:

    A container, tank or barrel used to hold used cooking oil that has been strained of food solids and will be removed by an oil recycling company.

75. Upload photo of GCD(s):
76. Upload photo of solid interceptor(s):
77. Upload photo of Grey Water Tank(s):
78. Upload photo of used cooking oil container(s):
80. FSE Used Cooking Oil (Yellow Grease) Recycling Information
82. Will cooking oil be used? *

    1. Yes
    2. No
83. Location of Used Cooking Oil (Yellow Grease) Storage Container/Tank
    -- Select One --Interior ExteriorOther
84. Other:
86. Is the Used Cooking Oil (Yellow Grease) Container shared with other FSEs?
    -- Select One --YesNo
87. Upload image of storage tank/container:*
89. Indirect Grease Hauler (Used Cooking Oil Removal Company):

    Please visit the link to see the list of haulers: IndirectGreaseHaulers.pdf (hrsd.com) 

90. Indirect Grease Hauler Phone Number:
92. Hood Cleaning Company:
93. Hood Cleaning Phone Number:
95. FSE Grease Control Device (GCD) Information

    Grease Control Device (GCD) or previously known as a grease trap, shall mean a device used to collect, contain, or remove food waste and grease from the wastewater while allowing the remaining wastewater to be discharged to the City/County/Town’s sanitary sewer system by gravity. Devices include: hydromechanical grease interceptors (HGI), automatic grease removal devices (AGRD), or gravity grease interceptors (GGI).

97. Total # of GCDs:
98. Does the FSE have GCDs in series (multiple GCDs connected)?

    1. Yes
    2. No
102. Does the FSE have a grease control device?*

     1. Yes
     2. No
103. Select all that Apply

     1. Exterior
     2. Interior
     3. Other
104. Describe Location of GCD?
105. Type of GCD:
     -- Select One --MetalPlasticConcreteFiberglass
107. Gallons Per Minute (GPM)
108. Grease Capacity (Lbs.)
109. -------OR-------
110. Gallons (gal.)
112. Manufacturer
113. Model
114. Upload Before and After Cleaning Photos:*
116. Is the FSE self cleaning? *

     1. Yes
     2. No

     *GCDs greater than 25gpm/50lbs are required to be cleaned by a certified commercial hauler.

117. Describe self cleaning procedure and waste disposal:*
119. Cleaning frequency (select all that apply):

     1. Monday
     2. Tuesday
     3. Wednesday
     4. Thursday
     5. Friday
     6. Saturday

     1. Sunday
     2. 7 Days
     3. 30 Days
     4. 60 Days
     5. 90 Days
     6. Other:
120. Other
124. Do you have another GCD? *

     1. Yes
     2. No
126. Where is the GCD located?
127. Select all that apply:

     1. Interior
     2. Exterior
     3. Other
128. Please provide description:
130. Check One:

     1. Gallons Per Minute (GPM)/Pounds
     2. Gallons
131. Type of GCD:
     -- Select One --Metal PlasticConcreteFiberglass
133. Provide details:

     Please provide gallons per minute and grease capacity or total gallons.

135. Manufacturer:
136. Model:
138. GCD Cleaning Service Company/Person:
139. Phone:
141. Is the FSE self cleaning?*

     1. Yes
     2. No

     *GCDs greater than 25gpm/50lbs are required to be cleaned by a certified commercial hauler.

142. Upload Before and After Cleaning Photos:*
144. Describe self cleaning procedure and waste disposal:*
146. Cleaning frequency (select all that apply):

     1. Monday
     2. Tuesday
     3. Wednesday
     4. Thursday
     5. Friday
     6. Saturday
     7. Sunday
     8. 7 Days
     9. 30 Days
     10. 60 Days
     11. 90 Days
147. Other
148. Upload GCD equipment photo:
152. Do you have another GCD?*

     1. Yes
     2. No
154. Where is the GCD located?
155. Select all that apply:

     1. Interior
     2. Exterior
     3. Other
156. Please provide description:
158. Check One:

     1. Gallons Per Minute (GPM)/Pounds
     2. Gallons
159. Type of GCD:
     -- Select One --Metal PlasticConcreteFiberglass
161. Provide details:

     Please provide gallons per minute and grease capacity or total gallons.

163. Manufacturer:
164. Model:
166. GCD Cleaning Service Company/Person:
167. Phone:
169. Is the FSE self cleaning?*

     1. Yes
     2. No

     *GCDs greater than 25gpm/50lbs are required to be cleaned by a certified commercial hauler.

170. Upload Before and After cleaning photos:*
172. Describe self cleaning procedure and waste disposal: *
174. Cleaning frequency (select all that apply):

     1. Monday
     2. Tuesday
     3. Wednesday
     4. Thursday
     5. Friday
     6. Saturday
     7. Sunday
     8. 7 Days
     9. 30 Days
     10. 60 Days
     11. 90 Days
175. Other:
176. Upload GCD equipment photo:
178. GCD Hauler/Pumper:

     Please inform cleaning company that at each cleaning/pump out, manifests can be directly emailed to the City of Norfolk FOG Office:

179. Contact Information:

     fog@norfolk.gov

183. Please provide the following for review: Plans and Equipment Schedule*
184. Upload Plumbing Plans if available:
186. Certification

     I hereby certify that I am the owner/authorized representative to make entries and that the information on this sheet is correct. Any falsification, misrepresentation, or misleading information VOIDS this registration form.

188. Signature *
     Type name
189. Date*
     Date
193. Thank you for keeping Norfolk sewers grease free!
     Visit our FOG page for more information.

     Norfolk Department of Utilities - Division of Water Quality
195. 6040 Waterworks Rd., Norfolk, VA 23502
     Call or Text: 757-620-2688 Fax: 757-441-5639 Email: fog@norfolk.gov
197. Water and Sewer Main Break 24-HR Emergency (757) 823-1000
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200. 1. Receive an email copy of this form.
201. Email address

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