Los Angeles City Fire Department Telephone (213) 978-3700 Email: lafd.usttestnotify@lacity.org 200 N. Main St., 17th Fl., Los Angeles, CA 90012
Request for Information UST Records *COMPLETE ONE FORM FOR EACH ADDRESS 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 UST RECORDS. VISIT http://www.lafd.org/public-records TO VIEW LIST OF ALL UST RECORDS.
Active/Inactive UST records
Check all that apply:
Historical Files
Facility I.D. No: __________________________________________________________________________ Storage Address: ______________________________________________ Unit/Ste.:___________________ City: _______________________________________________________ Zip: ______________________ Reason for Request: _______________________________________________________________________
FOR OFFICE USE ONLY NO INFORMATION ON FILE HARD FILE DESTROYED INFORMATION AVAILABLE
Initial Fee*
x $11.00
Facility I.D. No.: ___________________________ Request No.: ______________________________ Processed Date: ____________________________
Request Review File Copies: # of pgs. ________x $0.10 =
APPT. TO REVIEW FILE: __________________
*Per Facility ID
Processor Signature:_________________________
TOTAL:
Allow 10 working days for processing:
$_______
$_____________________