Food Alert Electronic Notification Signup

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This form is used to capture a facility's information to add to the Environmental Health Department's electronic notification system.

* Indicates required question

Email *

Your email

Facility Name *

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Facility Street Address *

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Facility City

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Facility State

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NM

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Facility Zip Code *

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Facility ID Number (e.g. FA0000123 - found on permit)

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Phone *

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