Form Center

4. FOG FSE GCD Registration

   The fats, oils and grease (FOG), food service establishment (FSE), grease control device (GCD) Registration is required for all FSEs in the City of Norfolk.

6. Food Service Establishment Information
8. What brings you to the FOG Registration Form?*

   1. Requesting FOG Approval Letter for Business License
   2. Required per City FOG Inspection
   3. Requested to update FSE or GCD information
10. Which agency completes Food Safety Inspection for your establishment?*

    1. Virginia Dept. of Health (restaurants, mobiles, etc...)
    2. Virginia Dept. of Agriculture & Consumer Services (grocery stores, convenient stores, manufacturers, etc...)
    3. I do not know which agency inspects my food business.
14. Actions:*

    1. Existing Food Service Establishment
    2. Change of Ownership
    3. New Business
    4. Relocating Business
    5. Renovation/Addition
    6. New Build-out
    7. Shell Build-out (tenant unknown)
15. Permits:

    1. Building Permit
    2. Plumbing Permit
    3. Both
    4. None
16. Permit/Site Plan Number:
20. Trade Name or DBA (doing business as):*
21. Legal Business Name:*

    Example: LLC., INC., Corp.

23. Physical Address 1 (Include Unit, Suite, etc...)*

    Physical location of FSE /OR/ storage location for mobile vendor/food truck.

25. Address2
27. City*
28. State*
29. Zip*
31. Food Service Phone #:*
32. Food Service Email:
34. Property Contact / Management Company Name:
36. Contact Information (Phone/Email):
40. Type of FSE:*

    1. Full-Service Restaurant
    2. Fast-Food Restaurant
    3. Educational Institution
    4. Take-Out Only
    5. Bar
    6. Bar & Grille
    7. Cafeteria
    8. Coffee Shop
    9. Convenience Store
    10. Caterer
    11. Commissary
    12. Deli
    13. Frozen Yogurt
    14. Grocery Bakery

    1. Grocery Deli
    2. Grocery Meat Dept.
    3. Ice Cream
    4. Religious Institution
    5. Sandwich Shop
    6. Snack Bar
    7. Mobile Vendor/Food Truck
    8. Ghost Kitchen
    9. Pop-Up Kitchen
    10. Temporary Event Operator
    11. Farmers Market
    12. Food Manufacturer
    13. Other:
42. Other:
46. Choose the following:*

    1. Copy and paste link below, in space provided.
    2. Upload menu(s)or list of food document.
48. Upload link to menu here:
50. Upload Menu 1:
51. Upload Menu 2:
52. Upload Menu 3:
56. Do you wash forks, knives & spoons?*
    -- Select One --YesNo, single use plastic only.
57. Estimated number of meals sold per day:*
61. Person in Charge /or/ Owner:*
62. Title/Role:*
64. Phone #:*
65. Email:*
67. Additional Contact Name/Phone Number or Email:
71. 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):
73. 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

74. HR FOG Certified Employee:
75. Upload HR FOG BMP Certification Card:*
79. Commissary Kitchen Information - for non-brick & mortar businesses.

    Mobile vendors, food trucks, temporary event operators, food manufacturers, caterers or any food service businesses using a commercial kitchen for food processing and food waste disposal services in the City of Norfolk, must provide a copy of the commissary agreement.

    
    

81. Name of Commissary Kitchen:
83. Address1
84. Suite or Unit:
86. City
87. State
88. Zip
90. Commissary Agreement/Letter:
91. City of Norfolk Commissary FOG Approval Letter:

    If the commissary that will be used is located in Norfolk please upload a copy of the Commissary's FOG Approval Letter.

93. Mark all that apply:*

    1. I own my commissary. (A list of businesses must be included).
    2. I am adding a new business (ie. catering or food truck) that I own, to my commissary.
    3. I lease a space from a commercial commissary kitchen.
    4. Does not apply.
94. List of businesses operating out of my Commissary Kitchen:
98. FSE Used Cooking Oil (Yellow Grease) Recycling Information

    Yellow grease shall mean FOG used in food preparation that have not been in contact or contaminated with other sources such as water, wastewater or solid waste. An example of yellow grease is fryer oil, which can be recycled into products such as animal feed, cosmetics and alternative fuel. Yellow grease is also referred to as renderable FOG.

    Please visit the link to see the list of approved haulers: Record Lookup By Grease Hauler Company - HRFOG

100. Do you have a fryer? *
     -- Select One --YesNoN/A
102. Indirect Grease Hauler (Used Cooking Oil Removal Company):
103. Indirect Grease Hauler Phone Number:
105. Upload photo of storage tank/container:
106. Additional Photos:
110. Hood Cleaning Company Information:
112. Does the FSE have a hood system?*

     1. Yes
     2. No

     1. N/A
114. Hood Cleaning Company:
115. Hood Cleaning Phone Number:
119. Grease Control Device (GCD) Information, previously known as a grease trap.

     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).

121. Does the FSE have a grease control device?*

     1. Yes
     2. No
     3. I do not know.
122. Total # of GCDs:

     If there are more than two GCDs in the establishment, follow the form format below for additional GCDs.

123. Additional GCD Information:
125. Determining the Size of the Existing GCD:

     GCDs are sized based on Flow (GPM) and Capacity (Lbs.) or by Volume (gallons).  Most GCDs have a specification (spec) plate that will provide the information required.  If the GCD is missing the spec plate, the GCD can be measured: length x width x height

127. How to size a New GCD:
     HRRTS for GCDs

     New GCDs must meet the most current Hampton Roads Regional Technical Standards for Grease Control Devices, see link above and to request Appendix A at the following email: fog@norfolk.gov

131. GCD #1*

     1. Using existing GCD
     2. No GCD in FSE
     3. GCD needs replacement
     4. Installing a new GCD in a new FSE
     5. N/A
132. Upload Photo of GCD #1:
133. Upload Photo of Interior of GCD #1:
135. Manufacturer/Model:

     If unknown, leave blank.

136. Location:
138. What material is the GCD made of?
     -- Select One --MetalPlasticConcreteFiberglassOther
139. GPM/lbs.

     (Gallons Per Minute / Grease Capacity in pounds)

140. Gallons:

     If unknown, leave blank.

142. GCD Length (inches)
143. GCD Width (inches)
144. GCD Height (inches)
148. GCD #2*

     1. Using existing GCD
     2. No GCD in FSE
     3. GCD needs replacement
     4. Installing a new GCD in a new FSE
     5. N/A
149. Upload Photo of GCD #2:
150. Upload Photo of Interior of GCD #2:
152. Manufacturer/Model:
153. Location:
155. What is the GCD made of?
     -- Select One --MetalPlasticConcreteFiberglassOther
156. GPM/lbs.

     (Gallons Per Minute / Grease Capacity in pounds)

160. GCD Cleaning Requirements:

     
     

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

     The GCD must be cleaned before it reaches 25% total FOG + Solids for the total liquid depth, or per manufacturers requirements.  If you are unsure of cleaning requirements, please email: fog@norfolk.gov

     The longest period of time allowed between pump outs is 90 days or quarterly cleaning, whether or not the maximum grease capacity is met. 

     Every GCD must be cleaned 4 times a year at the minimum and records kept of each cleaning and disposal.

     Please visit the link to see the list of approved haulers: Record Lookup By Grease Hauler Company - HRFOG

164. Is the FSE self cleaning? *

     1. Yes
     2. No
     3. N/A

     Self-cleaning by the owner and/or operator of an establishment is not allowed unless approved by the sanitary sewer system owner.

     Only hydromechanical grease interceptors (HGIs) with a liquid volume of 25 GPM (50 pounds) or less may be considered for self-cleaning unless otherwise approved by the sanitary sewer system owner.

     When approved, the owner and/or operator of an establishment shall comply with the following requirements for maintenance as required by the sanitary sewer system owner:

     • Remove cover(s)

     • Remove all fats, oils, and grease (FOG), solids, food debris, and wastewater

     • Clean all internal surfaces from the build-up of FOG or other residual materials (chemicals and/or degreasers are prohibited)

     • Place all removed materials in garbage bag or other sealable container (not glass) along with an absorbent material, i.e. like kitty litter or auto oil absorbent, and dispose of solidified contents in trash receptacle

     • Inspect all internal components, replace anything missing or broken and ensure flow control device is installed

     • Refill with fresh water

     • Replace cover(s) • Enter the required information on the maintenance log

     At least once per quarter or as required by the sanitary sewer system owner, the HGI shall be cleaned by a professional grease hauler, certified through the HR FOG Program administered by the Hampton Roads Planning District Commission, documented by a manifest, reported in the maintenance log, and all records maintained for the previous three (3) years.

166. Explain cleaning procedures and frequency:
168. Provide reason for request for self-cleaning:
172. Commercial Cleaning Frequency by approved grease hauler:

     The longest period of time allowed between pump outs is 90 days or quarterly cleaning, whether or not the maximum grease capacity is met. 

     
     

174. Name of GCD Cleaning Company:
175. GCD Cleaning Company Contact Number/Email:
179. Email photos of before and after cleaning of GCD and manifest or log to: fog@norfolk.gov

     If you have cleaning manifests for FSE that is being registered, upload documents and photos below:

183. Upload Kitchen Plans and Equipment Schedule*
184. Upload Additional Plans:
185. Appendix A or additional upload:
187. 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.

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

     Norfolk Department of Utilities - Division of Water Quality
196. 6040 Waterworks Rd., Norfolk, VA 23502

     Call or Text: 757-620-2688 Fax: 757-441-5639 Email: fog@norfolk.gov

198. Water and Sewer Main Break 24-HR Emergency (757) 823-1000
Leave This Blank:


202. 1. Receive an email copy of this form.
203. Email address

     This field is not part of the form submission.

204. Submit Submit and Print

* indicates a required field