Public Records Request – Diablo Water District

Public Records Request Form

To expedite your request for District records, please fill out this form completely. Identify specifically the type of record or document you are requesting - one record type per form. Requests should reasonably describe identifiable records prepared, owned, used, or retained by the District. Staff are available to assist you in identifying those records in the District's possession. The District is not required by law to create a new record or list from an existing record. Please note that if you are requesting the opportunity to inspect records, the District must be given time to locate and review documents that are responsive to your request in order to comply with the provisions of the Public Records Act. Pursuant to Public Records Act Gov’t Code 6250-6276.48, the District has 10 days to decide if records will be provided. In certain instances, and with written notice, the District may give itself an additional 14 days. You will, therefore, be requested to make an appointment to return at a later date to view the documents requested.

The cost for copies is $0.25 per page for black and white, and $0.50 per page for color copies.

REQUESTOR INFORMATION

REQUESTOR NAME *

First

Last

COMPANY (if applicable)

MAILING ADDRESS

Address Line 1

Address Line 2

City

State

Zip Code

CONTACT #: *

FAX #:

EMAIL *

REQUESTED RECORD OR DOCUMENT

NAME OF RECORD OR DOCUMENT: *

RECORD OR DOCUMENT DESCRIPTION: *

TIME PERIOD OF DOCUMENT REQUESTED

FROM *

Date Requested

TO: *

Date Requested

By submission of this form, I am requesting copies of the record(s) or document(s) indicated above, and hereby agree to reimburse Diablo Water District for the direct cost of duplicating the requested records in accordance with Gov. Code Sec. 6253(b).

Electronic Signature *

By selecting the "Submit" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement and consent to be legally bound by this Agreement's terms and conditions.