* Required

Date (mm/dd/yyyy)

I am requesting access to data in the following way:

(Note: inspection is free but reimbursable copy and/or staff time costs may apply to other requests.)

Inspection Copies Both inspection and copies

These are the data I am requesting:

Describe the data you are requesting as specifically as possible.

Contact Information

Name

Address

Phone

You do not have to provide any of the above contact information. However, if you want us to mail/email you copies of data, we will need some type of contact information. In addition, if we do not understand your request and need to get clarification from you, without contact information we will not be able to begin processing your request until you contact us.

We will respond to your request as soon as reasonably possible (usually within 30 days).

Please send a confirmation email to the address below: