Los Angeles City Fire Department Telephone (213) 978-3691 Email: LAFDrfi@lacity.org 200 N. Main St., 17th Fl., Los Angeles, CA 90012
Request for Information Hazardous Materials Records *COMPLETE ONE FORM FOR EACH ADDRESS/FACILITY Request Date: ________________ Requester’s Name:__________________________________ Email: _______________________________ Company/ Agency: __________________________________
PH.#: _______________________________
Address: __________________________________________________ Unit/Ste.: _____________________ City: ___________________________________ State: _____________
Zip: ______________________
Information is requested for PLEASE NOTE: YOU MUST PROVIDE A FACILITY ID # FOR ACTIVE/INACTIVE RECORDS. VISIT http://www.lafd.org/public-records TO VIEW LIST OF ALL HAZARDOUS MATERIALS RECORDS.
Check all that apply:
Inventory Summary
Review File
Facility ID No: __________________________________________________________________________ Storage Address: ______________________________________________ Unit/Ste.:___________________ City: _______________________________________________________ Zip: ______________________ Reason for Request: _______________________________________________________________________
FOR OFFICE USE ONLY NO INFORMATION ON FILE HARD FILE DESTROYED INFORMATION AVAILABLE
Fee Schedule: Inventory Summary*
x $11.00
Facility I.D. No.: ___________________________
Request Review File Copies:
Request No.: ______________________________
Initial Fee *
$ 1.10
Processed Date: ____________________________
# of pgs. ________x $0.10 =
$_______
APPT. TO REVIEW FILE: __________________
*Per Facility ID
Processor Signature:_________________________
TOTAL:
Allow 10 working days for processing:
$_____________________