Application for Temporary Food Service Permit

Pre-Application Questions
Will food be served within the limits of the Municipality of Anchorage (includes Anchorage, Chugiak, Eagle River, and Girdwood)?*

Yes, food will be served within the Municipality of AnchorageNo, food will be served outside of the Municipality of Anchorage
Incorrect Application

The state does not issue food permits for temporary food service within the Municipality of Anchorage.

A temporary food service permit from the Anchorage Health Department's Food Safety and Sanitation program is required.
Will any preparation of food or drinks be done at home? This includes steps such as chopping vegetables, mixing sauces, cooking, cooling, and other activities to prepare for food service.*

Yes, some or all of the preparation will be done at homeNo, all preparation will be done on-site at the temporary food service or off-site at an approved kitchen facility
Food Permit Not Available

All food served under a temporary food service permit must be prepared at the temporary food service booth or at an approved kitchen facility.

The state does not issue food permits to operations that use a private home kitchen. If you plan to prepare food at your home, the Exemption for Homemade Food may be an option for your operation.

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Before You Start
Allow Enough Time to Complete the Application

It is best to work on this application when you have time to complete the entire application.

Incomplete applications are not saved, so you may have to start over if you cannot complete and submit your application at this time.

Collect Required Documents

Some applicants may be required to upload documents as part of their application. Documents that may be required include:
- Agreement for Use of an Approved Kitchen Facility - this document is required if an approved kitchen facility is used to prepare food
- IRS Determination Letter - this document is required if the operator is a 501(c)(3) organization claiming fee-exempt status
- Operator's Food Worker Card or Food Protection Manager Certificate - one of these documents is required if the permit is four days or more

Application Steps
1. Application: Complete the online application form; all fields are required unless marked "Optional"
2. Payment: Pay the permit fee
  - After submitting the application, you will receive an email from dec.adec.userfees@alaska.gov with the subject "Quote from Alaska DEC"
  - Permit applications are reviewed after payment is received
  - Temporary food service permit fees are not refundable
3. Application Review: The reviewer will contact you to discuss your permit application
4. Permit: You will receive your temporary food service permit by email after your application is reviewed and the permit is issued
Questions?

Please visit Temporary Food Service or contact the permit coordinator at dec.fsspermit@alaska.gov.

Operator Information
Name of Food Service Booth*
Name of Operator or Responsible Person*

First NameLast Name
Phone Number*
Email Address*

Confirmation EmailApplication confirmation and payment emails will be sent to this email address
Mailing Address*

Street Address

Street Address Line 2

City or CommunityState

Zip Code
Has this food service ever been permitted? (This helps us find your record in our system.)*

Yes, this food service has previously had a permitNo, this food service has never had a permitI'm not sure

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Event or Location Information
Will the temporary food service be part of an event?*

Yes, food service will be at an eventNo, food service will be at a location where there is not an event
What is an event? Visit Food Service at an Event to learn how an "event" is defined in the food code.
Is this permit application for one of the following events?*

Alaska State Fair (Palmer)Tanana Valley State Fair (Fairbanks)Tanana Valley Farmers MarketNo, this permit is not for any of the events listed above
Name of Location Where Food Will Be Served*
For example, "Lowe's parking lot"
Name of Event Where Food Will Be Served*
For example, "Friday Fling Market"
Address Where Food Will Be Served*

Street Address

Street Address Line 2

City or Community

Zip Code
Name of Event Where Food Will Be Served*
Address Where Food Will Be Served*
2075 Glenn Highway Palmer, AK 99645
Name of Event Where Food Will Be Served*
Address Where Food Will Be Served*
1800 College Road Fairbanks, AK 99709
Name of Event Where Food Will Be Served*
Address Where Food Will Be Served*
2600 College Road Fairbanks, AK 99709

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Document Upload
Agreement for Use of an Approved Kitchen Facility*

Required for temporary food services that use an approved kitchen facility to prepare food
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IRS Determination Letter*

Required for 501(c)3 organizations that claim fee-exempt status
Cancelof
Operator's Food Worker Card or Food Protection Manager Certificate*

Required for operators who have temporary food service permits that are four days or longer
Cancelof
Drawing of Booth Layout

When your application is reviewed, the reviewer may contact you to request a drawing that shows the layout of your temporary food service booth.

You can choose to upload a layout now or the reviewer will let you know if one is needed.

If you submit a drawing of your booth layout, be sure it includes the location of handwashing, equipment, storage, work areas, and dishwashing (if you are washing dishes at the booth).
Drawing of Booth Layout (Optional)

Cancelof

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Acknowledgments
Menu Limited to Items on Permit*

I understand that only the foods listed on the permit can be served by the temporary food service.
No Barehand Contact with Ready-to-Eat Food*

I understand that barehand contact with food that is ready-to-eat is prohibited. Food service staff will wear gloves and/or use tongs and other utensils so that ready-to-eat foods are not touched by bare hands.
Sanitation of Food Contact Surfaces*

I understand that a sanitizer bucket or spray bottle must be available to sanitize food contact surfaces, such as counter tops. If a bucket and wiping cloths are used, the cloths will be stored in the sanitizer when they are not in use. If a spray bottle is used, paper towels will be used to wipe down the surfaces.
Water Storage*

I understand that water used to prepare food, wash dishes, and wash hands must be kept in containers that are clean, protected from contamination, and used only for storing water.
Wastewater Disposal*

I understand that wastewater must be disposed of at an approved location, such as an RV park or the drains at an approved kitchen. Wastewater from the food service will not be poured into storm drains or onto the ground.
Booth Construction*

I understand that the food service booth must be set up in a way that restricts access and protects the interior from weather and dirt.

Certification and Estimated Fee
I certify that I am familiar with the temporary food service requirements of the Alaska Food Code and that the temporary food service described in this application will be operated and maintained in accordance with the regulations.
Would you prefer to sign directly on this form or upload an image of your signature?*

Sign directly on the formUpload a signature file
Applicant's Signature*

Clear
Applicant's Signature (Upload Image)*

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Estimated Total Permit Fee
This will be confirmed by FSS staff at time of payment
This application is after the deadline and an additional fee has been applied.
Should be Empty:

	N/A	Will be Done at the Food Service Booth	Will be Done at the Approved Kitchen	Notes (Optional)
Thawing
Cutting, Chopping, Mixing
Cooking, Heating, Reheating
Cooling, Refrigerating, Cold-Holding
Hot-Holding
Assembling, Portioning, Serving

	N/A	Will be Done at the Food Service Booth	Will be Done at the Approved Kitchen	Notes (Optional)
Thawing
Cutting, Chopping, Mixing
Cooking, Heating, Reheating
Cooling, Refrigerating, Cold-Holding
Hot-Holding
Assembling, Portioning, Serving

	N/A	Will be Done at the Food Service Booth	Will be Done at the Approved Kitchen	Notes (Optional)
Thawing
Cutting, Chopping, Mixing
Cooking, Heating, Reheating
Cooling, Refrigerating, Cold-Holding
Hot-Holding
Assembling, Portioning, Serving

	N/A	Will be Done at the Food Service Booth	Will be Done at the Approved Kitchen	Notes (Optional)
Thawing
Cutting, Chopping, Mixing
Cooking, Heating, Reheating
Cooling, Refrigerating, Cold-Holding
Hot-Holding
Assembling, Portioning, Serving

	N/A	Will be Done at the Food Service Booth	Will be Done at the Approved Kitchen	Notes (Optional)
Thawing
Cutting, Chopping, Mixing
Cooking, Heating, Reheating
Cooling, Refrigerating, Cold-Holding
Hot-Holding
Assembling, Portioning, Serving

Fee Calculation - HIDDEN