2. Company Name
4. First Name
5. Last Name
7. Address 1
9. Address 2
11. City
12. State
13. Zip
15. Phone Number (Business)
16. Phone Number (Mobile)
18. E-mail
20. Attach copy of Georgia FOG Transporter Registration*
    All transporters are required to register with the Environmental Protection Division
21. Attached copy of Georgia FOG Transporter Registration*

    1. Yes
    2. No
23. Attach copy of Certificates fro General Liability & Automobile Liability Coverage*
    All transporters must carry general liability and automobile liability coverage
24. Attached Certificates for General Liability & Automobile Liability Coverage*

    1. Yes
    2. No
26. Thank you for your interest in serving as a commercial waste transporter in Athens-Clarke County. For more information on the Georgia Commercial Transporter requirements, visit www.georgiafog.com.
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field