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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:

$_______

$_____________________

Request for Information - UST  
Request for Information - UST