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FOG Registration Form for Businesses Working out of Selden Market

  1. FOG Registration at Selden Market

    Selden Market

    208 E. Main St.

    Norfolk, VA 23510

  2. Food Service Information
  3. (Trade Name)

  4. ie.  LLC., INC., Corp.

  5. Actions:*
  6. Which agency completes Food Safety Inspection for your establishment?*
  7. Type of FSE:*

    Select all that applies.

  8. Commissary can be located in any locality.

  9. HR FOG Best Management Practices (BMP) Certified?

    If No, please visit the following link to complete the Online Free FOG Training:

  10. 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.

  11. Type name
  12. 6040 Waterworks Rd., Norfolk, VA 23502

    Call or Text: 757-620-2688 Fax: 757-441-5639 Email:

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

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