Food Service Establishment (FSE) Registration & FOG Permit Renewal Form
  • BEFORE YOU BEGIN, NOTE:

    A valid EMail address is required for this form.
    Setup an account or get a free email account at: https://www.google.com/accounts/NewAccount?service=mail
  • Name of Food Service Establishment
  • Exact Street Address and physical location in Columbia, TN
  • Enter First then Last Name (ex. John Doe)
  • Contact Information

  • - -
  • REQUIRED: Confirmation will be sent by email.
  • Enter complete Mailing Address even if same as Street Address
  • Operational Information:

    Please complete the following information to describe the establishment.
  • Business Name Owner
    Previous Business Was:
  • Type
  • Food Service Establishments are classed as defined by NAICS. For more information, the official U.S. Government web site is http://www.census.gov/eos/www/naics/
  • / /
    Opening date may be the date a prior business opened (if applicable)
  • Enter the business account number from your Columbia Power & Water System monthly bill.
  • Hours
    Monday - Friday
    Saturday
    Sunday
  • Grease Control Information

    Help us understand more about grease control efforts practiced by your business.
  • NOTE: A Grease Traps are usually located inside and connect to dish sinks and/or dishwashers. A Grease Interceptor is larger and normally located underground with manhole type access lids.
  • Enter # of Gallons or Pounds, then select the measurement type shown. If no Interceptor/Trap installed, enter 0 here then select N/A.

  • Select one. If No Interceptor or Trap installed, select Not Applicable
  • Indicate the number and interval. Examples : Every 2 weeks; Once a month; Once every X (number of) months; Twice a Year; etc
  • FSE materials and log forms are available on our website, http://www.columbiatn.com/FOG/FSE.htm
  • Comments & Additional Information

    If you selected OTHER for your business type, please describe. Use this space to add any comments you find may be helpful to us in reviewing this information. Thank you!
  • Certification of Information

    All the information provided herein is true and correct to the best of my knowledge.
  • Press Submit to finish! Thank you for completing the Columbia Wastewater FSE Questionnaire!