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2. Pumping Frequency Variance Request*

   1. Evaluation
   2. Re-Evaluation
4. First Name*
5. Last Name*
7. Food Service Establishment Name*
8. Upload Menu*
10. Address*
12. Email Address*
13. Phone Number*
15. Grease Interceptor service provider name*
17. Provider's Email Address*
18. Provider's Phone Number*
20. How is food prepared?*
22. How is food served? (types of places, wares, etc.)*
24. How is food waste disposed of?*
26. What are your kitchen cleanup procedures?*
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28. 1. Receive an email copy of this form.
29. Email address

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30. Submit

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