The Georgia F.O.G Alliance Commercial Waste Transporter Inspection Request

The Southeastern F.O.G Alliance

Commercial Waste Transporter Inspection Request for The State Georgia

The Georgia Commercial Waste Transporter Law requires every vehicle that transports non-hazardous commercial waste (Grease Traps, Sand Trap, Oil/Water Separators, and Grit Traps) to obtain a FOG Inspection and receive a FOG Permit. This page is designed to help you register for an inspection of your vehicle(s). This is the final phase of the Commercial Water Haulers Law. To obtain your final registration number and receive the inspection of your vehicle(s) please fill out the required information below and submit the data. If you have any questions about this form please contact us from our home page. The information you provide will be transmitted to the inspecting LGA that you request below. Please allow up to 48 hours for a response from the LGA.

COMPANY INFORMATION

Today's Date:*

MonthDayYear

Company Name:*

Company Address:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Company Phone:*

Company Fax:*

Company Owner Name:*

Company Point of Contact:*

Point of Contact E-Mail:*

EPD FOG Registration Number FOG -*

Company DOT Number:*

Type of Commercial Waste Transported*

IF YOUR COMPANY DOES SEPTAGE COMPLETE BELOW INFORMATION

DPH Septage Removal Permit #:

County Permit Issued by:

TRUCK INFORMATION

Truck #1 VIN Number of Unit

Truck #1 Unit Number:

Truck #1 Tag Number:

Truck #1 Gallons

Truck #1 FOG Number:

Truck #2 VIN Number of Unit

Truck #2 Unit Number:

Truck #2 Tag Number:

Truck #2 Gallons

Truck #2 FOG Number:

Truck #3 VIN Number of Unit

Truck #3 Unit Number:

Truck #3 Tag Number:

Truck #3 Gallons

Truck #3 FOG Number:

Truck #4 VIN Number of Unit

Truck #4 Unit Number:

Truck #4 Tag Number:

Truck #4 Gallons

Truck #4 FOG Number:

If you have more trucks please fill out multiple forms

GEORGIA APPROVED DISPOSAL FACILITIES YOU PLAN TO DISPOSE AT:

Facility #1 Name:*

Facility #1 Address: ( Ex. Address, City, State, Zip )*

Facility #1 Phone:*

Facility #1 Point of Contact:

Facility #2 Name:

Facility #2 Address: ( Ex. Address, City, State, Zip )

Facility #2 Phone:

Facility #2 Point of Contact:

Facility #3 Name:

Facility #3 Address: ( Ex. Address, City, State, Zip )

Facility #3 Phone:

Facility #3 Point of Contact:

If you have more than 3 disposal locations please inform the inspector so that they can be added to your permit.

I am requesting a permit to pump commercial waste in the State of Georgia. I have read the Water Quality Rules and Regulations Chapter 391-3-6.24 and understand them completely. I understand that the entire contents of the commercial waste tanks must be removed and disposal of the contents, within the State of Georgia, can only be at an Georgia Environmental Protection Division approved facility. I certify under penalty of law that this documents information was prepared under direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.

Electronic Signature: ( Please input your full name )*

REQUEST INSPECTOR AND INSPECTION DATE AND LOCATION:

Request Inspection From: ( Inspecting LGA"s )*

Inspection Date Requested:*

DateHourMinutesAM/PM Option

Inspection Location ( Please give full address or description )*

Please let us know your human. Please enter the word shown*