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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:

$_____________________

Request for Information - Hazardous Materials  
Request for Information - Hazardous Materials