Grease Trap Questionnaire


Please correct the field(s) marked in red below:

Please complete this form if you have received a letter from the City of Janesville Water Utility regarding your structure’s grease traps. Contact the Water Utility with any questions at 755-3115.
1. Please enter the unique identification number located on the letter you received (Example: SGT001):

2. Business Name:

3. Business Phone Number:

4. Business Address:

5. Business Address City:
6. Business Address State:

7. Business Address Zip Code:

8. Mailing Address:

9. Mailing Address City:

10. Mailing Address State:

11. Mailing Address Zip Code:

12. Local Contact Name:

13. Local Contact Phone Number:

14. Local Contact Email Address:

15. Website:

16. If you are a tenant, please enter the property owner's information:

17. Property Owner Name:

18. Property Owner Address:

19. Property Owner Address City:

20. Property Owner Address State:

21. Property Owner Address Zip Code:

22. Property Owner Phone Number:

23. Business Activities: Please give a brief description of all business operations:
24. Does your facility have a kitchen or cooking area?
25. What type of grease trap/interceptor does your facility have?
26. Name of Hauler that services your trap/interceptor?
27. Does your facility have a catch basin(s) on site?

28. If yes, how many?

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