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Food Service Establishment (FSE) Registration & FOG Permit Renewal Form

  1. A valid email address is required for this form.
  2. Confirmation will be sent by email.
  3. Complete even if same as Street Address.
  4. Was a previous business located at this address?*
  5. North American Industry Classification System( NAICS) Class
    Food Service Establishments are classed as defined by NAICS. For more information, the official U.S. Government web site is
  6. Days of Operation*
  7. Equipment Information*
  8. Do you have a grease interceptor or grease trap installed?*
  9. Enter number of Gallons or Pounds, then select the measurement type shown. If no interceptor or trap is installed, enter 0 here then select N/A for measurement type.
  10. Measurement Type*
  11. Do you have tools to remove the interceptor or trap lids?*
  12. Will a member at your establishment be available during business hours to open the access lid(s) to the grease interceptor and/or trap?*
  13. Do you use maintenance logs?*
  14. Are oil & grease emulsifiers being used?*
  15. Use this space to add any comments you find may be helpful to us in reviewing this information. Thank you!
  16. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.*
  17. Leave This Blank:

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