HomeMy WebLinkAboutPRR26501 Vong - Fire Report Incident #22-06225Fire Department
21 60 Santa Barbara Avenue San ruis ChisLl0. iA 93dC1 '5?40
EC5.7Br 7340
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RecoRbs nequest
(Return to the City Fire Department)
This form will enable us to accurately and efficiently fill your request. With the exception of certain
records, report copies are 40C per page.
1/zq/rcDATE OF REQUEST:
NAME:
ADDRESS:
PHONE:
E-MAIL:
t^
FAX:
Please provide specific information (date, time, event, location,
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number)
YOUR REQUEST WILL BE PROCESSED lN COMPLIANCE WITH THE PUBLIC RECORDS ACf. catifornio Government code
Section 6253 (c). Each agency, upon o request for a copy of records, shdll, within 70 days from receipt of the request, determine whether
the request, in whole or in part, seeks copies of disclosable public records in the possession of the agency and shall promptly notify the
person moking the request of the determinotion and the reasons therefore.
ln unusuol circumstances, the time limit prescribed in this section moy be
extended by written notice by the head of the agency or his or her designee to
the person moking the request, setting forth the reasons for the extension
ond the dote on which o determination is expected to be dispdtched. No
notice sholl specifu o date thot would result in an extension for more thon 74
days. Pursuont Californio Government Code Section 6254 (c) Personnel,
medical, or simildr files, the disclosure of which would constitute dn
unwarrdnted invasion of personal privacy [ore exempt from disclosure].
lf you need assistance with this request or wish to review
the records on site, please call the City Fire Department
in advance at 781-7380 to schedule an appointment.
REQUEST: tr Picked Up
tr Mailed E Emailed
E Destroyed (not picked up within 30 days)
Return form to Administrative Assistont
FOR OFFICIAL USE ONLY
RECEIVED BY:
ASSIGNED TO:
COMPLETED BY:
Thank you.
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