Eligibility Confirmation

Resource Links:
Firefighting Substances Disposal Reimbursement Program
State of Alaska Vendor Customer Numbers (VCN)
Applicant
Municipality/Entity
The Municipality field is required.
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The VendorNumber field is required.
Contact
The FirstName field is required.
The LastName field is required.
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The Phone field is required.
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The Email field is required.
The Address1 field is required.
The City field is required.
State:
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The Zip field is required.
Eligibility
Please check the applicable eligibility criteria:
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Estimate of Disposal or Replacement Cost
Type of Reimbursement
Please note that requests are only being accepted at this time for activities related to the proper disposal of PFAS-containing AFFF (option 1).
Please check the type of reimbursement for which you are applying:
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Please ensure your cost estimate includes all eligible expenses, such as packaging materials, transportation to the disposal facility, third-party vendor fees, disposal costs, and any other relevant expenses.
Attachments(files must be smaller than 50mb in size.)
Attachments(files must be smaller than 50mb in size.)
Confirmation
You must fix the missing or invalid entries Òbefore you can confirm and submit.
By checking this box, I, hereby certify that the information provided in this eligibility confirmation submission form on behalf of the applicant, is true and accurate to the best of my knowledge.