Fillable Fire Report Request Form (City of Chandler)

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Fire Report Request Form (City of Chandler)

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Types of Request
Incident Report – This report provides general information about any incident to which the Chandler Fire
Department responded. The report will not provide any medical or HIPAA regulated details.
Occupancy Inspection Report – This report provides information related to code violations or business inspections
completed by a Fire Prevention Specialist.
Environmental Assessment Report – This report provides information regarding a property’s previous incidents of
hazmat, chemical leaks, or spills.
REPORT INFORMATION
Requested Report Type: Incident Occupancy Environmental
Incident / Inspection Date:
Name (of owner/business):
Incident / Address Location:
REQUESTOR’S INFORMATION
Date of Request:
Name:
Address:
Email:
P
lease sign page 2.
Mailing Address:
PO Box 4008, MS 801
Chandler, AZ 85224
Physical Address:
151 East Boston Street
Chandler, AZ 85225
FD Form No. 152
Rev. 3/26/19
Chandler Fire Department
Fire Report Request Form
Policy
Requests for Public Records for a Non-Commercial Purpose
Requests for Public Records for a Commercial Purpose
Non – Commercial
I declare that I have read and understood the Public Records Request Policy and General Information sheet (listed below)
regarding requests for public records from the Fire Department. The records that I am requesting are not for a commercial
purpose as defined by Arizona Revised Statues §39-121.03(D). These records are for my use; I will not sell them to another
person. I understand the City of Chandler does not guarantee the accuracy or completeness of these records and declare
the City of Chandler, its officers and employees free from any and all damages, lawsuits, causes of action and liabilities that
may result from my reliance upon and use of the above described information.
Commercial
Please call 480-782-2120 to inquire about the fee associated with commercial use.
Date:
Official Use Only
Received By:
Date:
It is the policy of the Fire Department to comply with all City, State of Arizona, and Federal laws and regulations regarding the release
of public records. Please be aware that the City may deny inspection of certain records if they are made confidential by State or
Federal law.
Please submit requests for inspection or copies of public records in writing, with adequate and detailed information. The City is not
responsible for creating new documents or generating reports in response to non-specific requests. Requests for copies of public
records for a non-commercial purpose will be processed within 10 working days, unless the request is for an unusually large
number of records. The City will charge a reasonable fee to cover reproduction expenses.
The Arizona Revised Statues §39-121.03(D) defines a commercial purpose as:
Sale or resale.
Producing a document containing all or part of the copy, printout or photograph for sale.
Obtaining names and addresses from public records for the purpose of solicitation or the sale of names and
addresses to another for the purpose of solicitation.
Any purpose in which the purchaser can reasonably anticipate the receipt of monetary gain from
The direct or indirect use of the public record.
It is a violation of the public record law to:
Obtain a public record for a non-commercial purpose and use it for a commercial purpose.
Obtain a public record for a commercial purpose and use it for a different commercial purpose.
Mailing Address:
PO Box 4008, MS 801
Chandler, AZ 85224
Physical Address:
151 East Boston Street
Chandler, AZ 85225
FD Form No. 152
Rev. 3/26/19
Please indicate whether you will use the records for a non-commercial or a commercial purpose.
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Fire Report Request Form (City of Chandler)

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Completed 14 July 2020

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