Seafood Processing Application - New/Change of Owner

Land-based Facility Information
Facility Name *
If you are leasing a facility - include a signed Letter of Agreement form (found on our website)
Previous Facility Name (If applicable)
Facility Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Location
Facility Contact *

First NameLast Name
Seasonal Phone Number *
Please enter a valid phone number.
Radio/cell Number
Facility Contact E-mail *
example@example.com
Facility Fax Number

Vessel Information
Vessel Name *
Previous Vessel Name (If applicable)
Vessel Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alaska ports/Mooring Locations (Dock Address or Physical Location) *
Vessel Contact *

First NameLast Name
Radio/Cell Number
Vessel Phone Number
Please enter a valid phone number.
Vessel Contact E-mail*
example@example.com
Vessel Fax Number

Seafood Processors Business Form A
Change of owner or Sale (check one)*

New owner (100% change of ownership)Partial change of ownership or merger
Business Information Supplemental (firms with more than one owner)

If there are more than 3 individuals in your business structure or multiple levels of ownership over a facility/vessel, please submit an organizational chart showing the relationship from the owner to the facility/vessel.
Parent Corporation Name (if applicable)
President, Owner, Partner
Name and Title
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
President, Owner, Partner
Name and Title
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
President, Owner, Partner
Name and Title
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
If there are more than 3 individuals in your business structure or multiple levels of ownership over a facility/vessel, please submit an organizational chart showing the relationship from the owner to the facility/vessel.

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Seafood Plan Review Checklist
General Information
Purpose

New OperatorNew ConstructionRemodel of Existing Structure
Plan Review Contact

First NameLast Name
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
Section A

Water Supply. All water supplied to the facility or vessel must comply with the requirements in 18 AAC 80 – Drinking Water. Contact the DEC Drinking Water Program to ensure the water supply you will be using meets these requirements: https://dec.alaska.gov/eh/dw
Water Source*

Public or Municipal Source, provide source name or PWSID# belowPrivate Well – groundwaterPrivate Well – groundwater under the influence of surface waterSurface Water (lake, stream, river)Collected rainwaterOther
Source Name, PWSID# or Other
Water Sampling

If you are not on a Public or Municipal water supply, you must submit water samples for Coliform testing before opening and every 30 days while processing.
What lab do you plan on using for water testing?
Certified Lab List for Water Testing: https://dec.alaska.gov/eh/lab/micro-lab-cert-status.aspx
Map and photo showing the location where water sampling will occur

Include a map and photo showing the location where water sampling will occur. Note: the location should be after treated and processing water areas and preferably on the end of the water line.
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Wastewater Disposal System

All domestic and seafood wastewater disposal must comply with the requirements of the Wastewater Program as specified in 18 AAC 72. Contact the DEC Water Program to ensure your methods of disposal meet these requirements: https://dec.alaska.gov/water/wastewater
How will you dispose of your domestic wastewater?*

Municipal System, Specify Municipal System belowSeptic System with Leach FieldHolding TankAt Sea (more than 3 nautical miles offshore)Other
Municipal System and Other
Solid Waste Disposal
Describe how you will handle and dispose of your non-seafood garbage*
What is your solid waste storage location?*
How often is solid waste removed from the premises?*
Seafood Waste Disposal
How will you dispose of your seafood waste?*

Land Burial, specify landfill (specify which one below)Water Discharge – contact DEC Seafood Wastewater PermittingList your APDES Permit# below
Landfill or APDES Permit#

Site Plan (applies to both vessels and land-based facilities)
Include a detailed drawing of the premises around the vessel (at the dock) or land-based facility that identifies the following items:
- Processing buildings
- Storage buildings
- Docks
- Other on-site areas that are used to support processing, storage, and transportation of seafood products
- Solid waste storage
- Potable water supply
- Oil and fuel tanks
- Delivery and loading access
- Sewage disposal system (i.e. septic system or Marine Sanitation Device)
- Roads, streets, alleys, landmarks (include GPS coordinates)
Upload Site Plan (applies to both vessels and land based facilities)*

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Equipment
Do you have any fixed or stationary equipment such as refrigerators, freezers, smokers, retorts, machinery for heading, gutting, filleting, or vacuum packagers?*
*If you checked yes: Include a numbered list of each piece of the equipment and indicate the locations on your floor plan.
Floor Plan (applies to both vessels and land-based facilities)
Include a detailed drawing of the facility or vessel layout, including each room or area (and purpose):
- Storage, processing, holding, cooling, and packaging
- Chemical storage
- Employee locker/dressing rooms
- Laundry facilities and clean/dirty storage clothing and linens
- Sleeping or living quarters
- Each toilet room
- Light fixture
- Each piece of fixed equipment
- Each air curtain, enclosed system, positive airflow system, double doors, etc. if used
Upload Floor Plan*

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Plumbing Schematic (applies to both vessels and land-based facilities)
Include a plumbing schematic showing the following:
- Pipes and piping used to supply potable water and non-potable water
- Each hand wash sink in or immediately adjacent to each processing area
- Wastewater lines, connections (including overhead and backflow prevention)
- Location of floor drains
- Hose bib
- Hot water generating equipment with capacity and recovery rate
Upload Plumbing Schematic*

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Finish Schedule

Describe the surface finish of walls, floors, and ceilings in each of the following areas:
Describe the surface finish of walls, floors, and ceilings in the processing area: *
Describe the surface finish of walls, floors, and ceilings in the packaging area: *
Describe the surface finish of walls, floors, and ceilings in the storage area: *

Packaging Material Storage
How will you store your packaging materials to protect them?*
Ingredients, Additives, Preservatives, and Allergens

Describe any additional items that go into or onto your product during processing, such as glazing agents, sulfites, herbs, and spices. If using a product, include a copy of the label that lists the product ingredients (ex. Frodex).
Allergens, Ingredients, Additives, Preservatives *
Please attach a sample label for the highest risk product produced (i.e. smoked, salted, or shelf-stable product) *

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Pest Control
Describe how the facility or vessel design helps to control pest activity. For example: self-closing doors, #16 mesh screens, air curtains, or covering over processing area (vessels only).*

Food service for employees
Will you be providing food service for your employees?
*If Yes, please e-mail: DEC.FSSPermit@alaska.gov or call 1-877-233-3663 to see if a permit is required under the Alaska Food Code (18 AAC 31)

Required Attachments
Recall Plan *

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Documentation of HACCP training

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Sanitation Standard Operating Procedures (SSOP): - that describes the sanitation procedures followed at the facility. All SSOP’s must addresses the 8 key points of sanitation listed in 21 CFR 123.11 and include monitoring frequencies and corrective actions that are specific to each key point.*

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Upload a flow for your highest risk product *

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HACCP Plan for the highest risk product *

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Smoker Heat Distribution Study *

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Cook Study for Cooking Operations (Other than LACF) *

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For Ready-to-Eat (not shelf stable) Products (ex. smoked salmon and crab) – Product test results per 18 AAC 34.125*

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For Thermal Retort: FDA forms 2541 and 2541(d) and process authority letters or schedule for all retort processes*

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Application for Seafood Processing and Ice Manufacturing Permits

Land-based Facility Information

Vessel Information

Product and Packaging Details

E. Distribution and Transportation

Seafood Processors Business Form A

Business Information Supplemental (firms with more than one owner)

President, Owner, Partner

President, Owner, Partner

President, Owner, Partner

Seafood Plan Review Checklist

General Information

Section A

Water Sampling

Wastewater Disposal System

Solid Waste Disposal

Seafood Waste Disposal

Site Plan (applies to both vessels and land-based facilities)

Equipment

Floor Plan (applies to both vessels and land-based facilities)

Plumbing Schematic (applies to both vessels and land-based facilities)

Finish Schedule

Packaging Material Storage

Ingredients, Additives, Preservatives, and Allergens

Pest Control

Food service for employees

Required Attachments

Section 3 - Fees and Payment

You will be contacted within 5 days for payment.