HomeMy WebLinkAboutPRR23099 McCondichie - 3650 Broad CUPA HazmatCOUNTY OF SAN LUIS OBISPO
Mk ENVIRONMENTAL HEALTH SERVICES DIVISION
ENVIRONMENTAL HEALTH SERVICES DIVISION
PUBLIC RECORD ACT REQUEST FORM
This form is not required to submit a request; however, this assists the Department identify records or data you
are requesting and track your request.
Per the California Public Records Act (CPRA), I hereby request reproduction of the following records maintained by
this department and understand that there may be fees incurred in the reproduction of the records.
Please complete the form below. If this department does not maintain your requested records this form will be
forwarded to the correct department, to the extent known.
YOUR NAME
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ORGANIZATION (IF APPLICABLE)
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MAILING ADDRESS (STREET AND UNIT NUMBER)
PHONE NUMBER
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FAX NUMBER
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CITY, STATE & ZIP CODE
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EMAILADDRESS
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RECORDS REQUESTED (where applicable, include on APN, property address, and/or other identifying information)
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YOUR SIGNATURE (TYPE NAME IF COMPLETING ONLINE)
TODAYS DATE
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CPRA requests may`6e submitted:
• Via Email: Email completed form to: ehs@co.slo.ca.us
Via Fax: Fax completed form to (805) 781.4211
• Via US Mail: Mail completed form to: 2156 Sierra Way, San Luis Obispo, CA, 93401
• In Person: Submit completed form to front counter staff.
A response will be sent to you within ten* business days of receipt of your request by this office. All payments are due at the
time record reproduction is provided.
Ouestions? Please contact us: (805) 781-5544
*In some Instances, the Department may require up to an additional 14 days to respond to a request as authorized by the Act.
PLEAse NoTE: The California Public Records Act (Govt Code Section 6250 et. seq.) applies to writings in County flies "containing information relating to the conduct of the
publics business prepared, owned, used, or retained by any state or local agency regardless of physical form or characterisdcs." The County will provide those documents to
you, unless they are exempt from disclosure under the Public Records Actor other legal reason prevents the documents from being disclosed to the public.