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Yellow Grease (Cooking Oil) Disposal Log

  1. FOG
  2. Enter Identifying Food Service Establishment (FSE) Information
  3. Enter Yellow Grease (used cooking oil) Disposal Information
  4. By law, records must be retained on-site for at least three years.
  5. Company name
  6. Pounds/gallons
  7. Optional
  8. Optional
  9. 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.
  10. Type name
  11. Address: 6040 Waterworks Rd., Norfolk, VA 23502
    O: 757-441-5678 ext. 229 M: 757-620-2688 Fax: 757-441-5639 Email:
  12. Water and Sewer Main Break 24-HR Emergency 757-823-1000
  13. Leave This Blank:

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