Requesting Fire Records

What type of records are you looking for? * Required
- Hazardous Materials
- Fire
- Medical (Ambulance)
- Other
If Other - please be as specific as possible
Request Date
MM slash DD slash YYYY
Incident Information
Incident Date * Required
MM slash DD slash YYYY
Incident Time
Incident Address / Location * Required
Street Address City
Name of Requestor
Name * Required
First Last
Agency / Company Name
Complete Mailing Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone * Required
Email * Required
Preferred Method of Contact * Required
Briefly Describe Request * Required
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Incident Information