Attachment_D_-_Fats,_Oils_and_grease_Waste_Disposal_Manifast.pdf
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- Solicitation number
- Y23-103
- Issued by
- Orange County, Orlando City, Florida
About this file
The document is a Fats, Oils and Grease Waste Disposal Manifest form developed by the Florida Industrial Pretreatment Association (FIPA), designed for documenting the collection and disposal of waste from interceptors, traps, and oil-water separators. The manifest provides a comprehensive template for capturing critical information about waste haulers, generators, device conditions, waste volumes, and disposal facilities. The form requires detailed documentation including vehicle information, device condition assessments, waste thickness measurements, and certification by both the customer and driver.
The standard drawing attached (Appendix A, Figure A307-1 dated April 24, 2009) provides technical specifications for a reinforced concrete grease interceptor, detailing construction requirements such as minimum 4000 PSI concrete at 28 days, 6-inch minimum thickness, precast baffle specifications, and clean-out configurations. The drawing includes specific design notes referencing Florida Plumbing and Administrative Code, specifying design parameters for grease interceptors in food service and beverage preparation areas, with requirements for water and gas tightness, and accommodations for H-20 truck wheel loads.
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Text version
�I Authority: Control Number:
Fats, Oils and Grease Waste Disposal Manifest
Hauler Information:
Name:
Address:
Vehicle Tag#:
Decal Number:
Generator Information:
Customer Name:
Physical Address:
'f.elephone #:
Phone#: _______ _
Capacity: ______ Gallons
Type of Device: ------i�iiiiiiiii ____________ _ Interceptor/Trap/OWS Condition: I,,, Baffle intact and unobstructed ] Needs Repair: _______ _ Cover secure, accessible & in good condition ] Needs Repair: _______ _ Inlet/ Outlet pipes intact . eeds Repair: _______ _ Walls & bottom in good condition ®;?>il�f.f:1lli!Needs Repair: _______ _
ESTIMATED Waste Thickness and Volume Removed from Interce tor/Tra /OWS Device:
Grease/Oil Cap: __ Inches Bottom S Total Device Depth __ Inches Volume Pumped: _____ Gallons
Certification: I certify that the above information is - rate. I further certify that said device was completely pumped and cleaned, and no materials wer into the device unless prior approval w�s received from the control authority of the Publicly t Works wastewater collection system. I understand that falsification of this information may b a violation of · e local code and ordinances and I may be subject to enforcement action in accordance with the ' therein.
Customer Signature: ---------� Print Customer Name: n
------------�""'--""·£/J:-5-��-- Driver Signature: _____________ _
Print Driver Name:
r1
· Date: _______ _
Date:
Discharge Approval: On the dates and times provi w, ,��l:'astes listed in this manifest were approved for discharge, and were disposed by the hauler at the folbwmg pemiittecf treatment fu.cilities:
Facility #1:
Facility Name:------------------------------ Waste Received Date: _______ Time: ___ _ Invoice/Ticket#:· _______ _
Operator Signature:
Facility #2:
Facility Name: _____________________________ _ Waste Received Date: _______ Time: ___ _ Invoice/Ticket#: _______ _
Operator Signature: ____________ _
Comments:
Florida Industrial Pretreatment Association (FIPA) Unified Manifest Form-Revision Date 4-19-201 I
GENERATOR, WASTE HAULER, WASTE DISPOSAL FACILITY, AND CONTROL AUTHORITY
RETAIN A COPY OF THIS UNIFIED MANIFEST FORM AT LEAST 3 YEARS 1N YOUR FILES.
ATTACHMENT D
File details come from the government source that posted it. Updated .