WEST MIFFLIN SANITARY SEWER MUNICIPAL AUTHORITY

www.wmssma.org

    1302 Lower Bull Run Road  

West Mifflin, PA 15122-2902

Phone: (412) 466-6070      Fax: (412) 466-8108

 

 

 

 

 

 

 

 

 

 

 

 

RIGHT-TO-KNOW REQUEST FORM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE REQUESTED:                                                                                                                   (mm/dd/yyyy)  

 

 

 

 

 

 

 

 

 

 

 

 

 

REQUEST SUBMITTED BY:                     E-Mail              U.S. Mail               Fax               In-Person

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF REQUESTOR (Optional):*                                                                                                              

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS (Optional):                                                                                                                        

 

                                                                                                                                                                              

 

                                                                                                                                               

 

CITY/STATE/COUNTY (Required):                                                                                                                   

 

 

 

 

 

 

 

 

 

 

 

 

 

TELEPHONE (Optional):.

 

 

 

 

 

 

 

 

 

 

 

 

 

RECORDS REQUESTED:                                                                                                                                   

 

**Be as specific as possible.                                                                                                                                

 

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DO YOU WANT COPIES?      YES   or     NO

 

DO YOU WANT TO INSPECT THE RECORDS?      YES    or    NO

 

DO YOU WANT CERTIFIED COPIES OF RECORDS?      YES    or      NO

 

 

 

 

 

 

 

 

 

 

 

 

 

RIGHT TO KNOW OFFICER:  General Manager/Assistant General Mgr.   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE RECEIVED BY WMSSMA:                                                                                                                        

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

**Written requests need not include an explanation why information is sought or the intended

 

 

use of the information unless otherwise required by law. (Section 703.)