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Grease Control Device (GCD) Cleaning Log

  1. FOG

  2. Enter Identifying FSE Information

  3. Enter GCD Cleaning Information

  4. Max amount of grease + solids (25% capacity):

    By law, records must be retained on-site for at least three years.

  5. Company or person

  6. Amount removed in inches

  7. Amount removed in inches

  8. This is the total of ALL liquids and solids (water + grease + solids, amount removed in inches)

  9. Calculation

    Grease (A) plus (+) Solids (B) divided by (/)Total (C) multiply by (X) 100 = Percent (%) of FOG

  10. A + B / C x 100 = % FOG

  11. For GCD units > 50 gpm/100 lbs.

  12. Certification

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

  13. Address: 6040 Waterworks Rd., Norfolk, VA 23502

    O: 757-441-5678 ext. 229 M: 757-620-2688 Fax: 757-441-5639 Email: UTFOG@norfolk.gov

  14. Water and Sewer Main Break 24-HR Emergency 757-823-1000

  15. Leave This Blank:

  16. This field is not part of the form submission.