Request for Public Records

Please complete all required fields and identify specifically the type of records you are requesting. Requests for records must be for clearly identifiable records in the possession of the Project and/or facilities within the jurisdiction of the Project.

Tri-Dam Project will acknowledge your request and provide an initial response to your request within ten (10) business days, in accordance with the California Public Records Act (Government Code §6253). [Note: Duplicate costs for black and white copies are $0 .24 per page; tapes are priced at the current cost for purchase by the district. In some instances, advance payment may be required]

Type of Request

Name (required)

Date (required)

Business Name (if applicable)

Property Address (required)

Mailing Address (required)

Assessor's Parcel Number(s) APN (required)

Telephone/Cellular Number (required)

Fax Number

Email Address (required)

Requested Information (required)

Description of Record

I hereby agree to pay the Tri-Dam Project for duplication of the requested records in accordance with Government Code section 6253(b) (required)

I acknowledge and agree to pay the Tri-Dam Project for duplication of the requested records in accordance with Government Code section 6253(b).

Signature (typed name) (required)

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