Department of Agriculture 635 Capitol St Salem, OR 97301?2532 . . 0b. Public Record Request Fmal calm Name Tracy Loew Date 08/12/2014 Af?liation Statesman Journal Address PO 80x13009 City salem State OR Zip 97309 Phone (5033995779 Fax Email tioew@statesmanjoumal.com Summary of public record request Food establishment inspection database and record layout, including field descriptions. Records search $30.00 per hour, with a minimum charge of $15.00 0.00 Copies $0.15 per page Electronic records search $50.00 per hour Photo color reprints $0.50 per photo Blue line drawings actual cost Audio tape. 90 minutes $5.00 each Express mailing, actual cost with a minimum charge of $9.00 Document certi?cation $2.50 per certi?cate Archive retrieval. actual cost with a minimum charge of $10.00 4 Other Database preparation $30.00 per hour 12000 Other - Total 120.00 Your request will be processed after payment is received per OAR 603-001-0160. (Please include a copy of this form.) Mail check or money order payment to Mail or fax credit card payment to Oregon Department of Agriculture Oregon Department of Agriculture PO Box 4395 Unit 17 635 Capitol St NE Portland. Oregon 97208?4395 Salem. Oregon 97301?2532 Fax: 503?986?4746 E3 VISA CI MasterCard Expirationdate Card number Total charges $120.00 Signature