PUBLIC RECORDS REQUEST
DATE OF
INCIDENT:
TIME:
TYPE OF
INCIDENT:
PM
LOCATION:
ADDRESS, ASSESSOR’S PARCEL NUMBER (APN) OR CLOSEST KNOWN LOCATION
CITY / STATE / ZIP
NAME OF BUSINESS, IF APPLICABLE
NAME:
ADDRESS:
CITY:
STATE / ZIP:
TELEPHONE:
EMAIL:
RECORDS REQUEST
S
END REPORT TO THE FOLLOWING:
COMPLETE AND MAIL THIS FORM TO:
RIVERSIDE COUNTY FIRE DEPARTMENT
ATTENTION: CUSTODIAN OF RECORDS
210 WEST SAN JACINTO AVENUE
PERRIS, CA 92570
AM
MEDICAL
FIRE
MINOR REPORT
OTHER
Please describe the records you are seeking below:
___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
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