Grease Barrel Collection Log GREASE BARREL COLLECTION LOG
(Form 219-5)
KEEP ON FILE ON PREMISES FOR NO LESS THAN 2 YEARS.
“Think before you put it down the Sink”
INSTRUCTIONS: To be filled out by the Food Service Establishment and filed in the FSE On-Site
Compliance Binder. Use this form to record grease collection pick-up times and volumes. The company
collecting the waste grease should sign this form if possible. If this form is not available when pick-ups
are made, the collecting company should leave a signed receipt with the collection information. Record
that information on this log.
Business Name:
Address:
MANAGER: Your initial on this form acknowledges that the service establishment has
disposed of its grease in a lawful manner and accounts accurately for the volume of
grease disposed.
Date Serviced by Volume MGR Comments
City Code Section 13-101-6B. Documents must be kept on file for no less than two years. It shall be unlawful to make any
false statement, representation, record, report, plan or other document that is filed with the City.