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Hi-Desert Water District

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FOG Waste Discharge Inspection Application

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Steps

1. Business Information This section is complete This section is incomplete
2. Facility Information This section is complete This section is incomplete
3. Cooking Fixtures This section is complete This section is incomplete
4. Plumbing Fixtures This section is complete This section is incomplete
5. Grease/Oil Removal Devices This section is complete This section is incomplete
6. Additional Questions This section is complete This section is incomplete
7. Payment This section is complete This section is incomplete
8. Complete and Submit This section is complete This section is incomplete

Business Information

This property is a vacant lot or an unoccupied business?
1. Yes
2. No
If you answered Yes DO NOT PROCEED. Click on the link below and you will be redirected to a different application. If you answered No continue below without redirecting. Warning: If you click on the link you will leave this page.
Notification of Vacant Lot or Unoccupied Business
Business Name*
First Name of Business Owner*
First name only
Last Name of Business Owner*
Last name only
Phone Number*
Email Address*
First Name of Manager
Last Name of Manager
Phone Number
Email Address
Facility Address:
Street Number*
Street Name*
City*
State*
Zip Code*
Mailing Address (If different from Facility address)
Street Number
Street Name
P.O. Box
City
State
Zip Code
HDWD Account Number (if known):
From water/sewer bill. May be obtained from property owner/manager if they pay the water bill
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Facility Information

Please answer all questions as if your business is connected to the sewer system.
Check all that apply
1. Full Service Restaurant
2. Fast Food Restaurant
3. Cafeteria
4. Hospital
5. School/College
1. Bakery
2. Grocery Store
3. Church/Club/Organization
4. Nursing Home
5. Coffee Shop
1. Convenience Store
2. Auto Repair
3. Car Wash
4. Distillery
5. Other(Specify below)
Other:
Seating Capacity*
Hours of Operation(eg. 8 am-5 pm)*
Days of Operation*
1. 7 Days a week
2. Monday
3. Tuesday
4. Wednesday
5. Thursday
6. Friday
7. Saturday
8. Sunday
Number of Employees*
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Cooking Fixtures

Check all that apply
1. Dishwasher
2. Grill
3. Stove/Oven
4. Wok range
5. Rotisserie
1. Griddle
2. Oven (only)
3. Tilt kettle
4. Microwave Oven
5. Other(Specify to the right)
Other Cooking Fixtures
List all that are not included to the left
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Plumbing Fixtures

Check all that apply
1. Garbage grinder
2. Dishwasher
3. 1-compartment sink
4. 2-compartment sink
5. 3-compartment sink
1. Floor Drain(s)
2. Pre-wash sink
3. Mop sink
4. Other(Specify to the right)
Other Plumbing Fixtures
List any other fixtures not included to the left
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Grease/Oil Removal Devices

# of units
Check all that apply
1. Outside Grease Interceptor
2. Passive (Manual) Grease Trap
3. Mechanical Grease Removal Device
4. Oil / Water Separator
How often cleaned
1. Daily
2. Weekly
3. Monthly
4. Bi-Annaully
5. Annnually
6. Quarterly
Serviced by
1. Self
2. Hauler
Hauler Name (If applicable)
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Additional Questions

1. Does your business perform auto repair or equipment maintenance on site, such as oil changes or transmission maintenance? *
1. Yes
1. No
2. Do you have floor drains connected to the sewer system?*
1. Yes
1. No
1. Unknown
3. Do you have a grease barrel or bin used to dispose and/or recycle grease or oil?*
1. Yes
1. No
4. Is food prepared on site more than one day a week? *
1. Yes
1. No
If “Yes” to #4 approximately how many people food is prepared for?*
1. <10
1. 10-50
1. >50
1. N/A
5. Are there additives placed into the kitchen drains or grease removal device (i.e., enzymes, bacteria, etc.)?*
1. Yes
1. No
1. N/A
6. Are grills or deep fryers used to prepare food more than an average of 3 meals per week?*
1. Yes
1. No
1. N/A
7. Are dairy products rinsed down sink drains?*
1. Yes
1. No
1. NA
8. Are dishes, pots and pans washed on site? *
1. Yes
1. No
1. NA
9. Does the business use a distillation process?*
1. Yes
1. No
10. (If Yes to #9)Does any non-domestic discharge flow from distillation process into the drains connected to the collection system? *
1. Yes
1. No
1. NA
Approximate volume of liquid discharged from distillation process into drains following production(gallons per day):*
1. <200
1. 200-725
1. >725
1. NA
11. Are there any chemicals used in the distillation process that flow into the drains? If Yes, list chemicals below. (Lab results and/or MSDS require review before permit will be issued)*
1. Yes
1. No
1. NA
Chemicals:
For Distilleries: Please provide MSDS for the chemicals used in your process
12. Is the business a dental office?*
1. Yes
1. No
1. NA
13. If Yes to #12, Is Amalgam discharged during the dental process? *
1. Yes
1. No
1. NA
14. If Yes to #13 Do you have an Amalgam separator installed?
1. Yes
1. No
1. NA
If #14 answer is No an Amalgam separator will need to be installed before a permit can be issued.
For businesses preparing food and auto repair shops with drains connected to the collection system, please provide a copy of a plot/plumbing plan. If no professional drawing exists, a hand-drawn copy is acceptable. A blueprint of the facility showing the required information may also be attached. This is NOT required for renewal applications unless specifically requested.
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Payment

Payment Information
There is no application fee for the Fats, Oils, and Grease Waste Discharge Permit. If Hi-Desert Water District Staff determines a permit is needed, your company will be asked to submit a $100.00 inspection and permitting fee. Check payments should be mailed to the District's Wastewater Reclamation Facility at 58950 Sunnyslope Drive in Yucca Valley, California.
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Complete and Submit

I solemnly affirm under the penalties of perjury, and to the best of my knowledge, information and belief, that the contents of this application are true and complete.
Owner/Authorized Representative
Print Name Here
Title
Print Your Title Here
Date*
Date

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Contact Us

Hi-Desert Water District
55439 29 Palms Highway
Yucca Valley, CA 92284
Phone: 760-365-8333
Hours: 7:30 a.m. to 5 p.m.
Monday through Thursday

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Why are Hi-Desert Water District’s rates different than those of neighboring water agencies?
What is the money we pay on our monthly water bill used for?
Can I make a payment directly to field employees at the time they are locking off my service?

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