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Environmental Health Complaint
Please fill out this form for any complaints dealing with Public Pools or Spas, Sewage Disposal, Housing, or Hazardous Materials.
Fields with an asterisk (*) are required.
RM EH Complaint
Your Information
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* Name:
Daytime Phone:
Address:
* Email:
City:
Other Contact Info:
Contact ASAP?
Please contact me as soon as possible regarding this matter
Complaint Location
- Please provide as many details as possible
* Address/Street Name:
City:
Other identifying landmarks, directions
Facility Name or Owner
- If known, provide as much information as possible
Name:
Phone Number:
Address:
City:
Email:
Other Contact Info:
Please describe the nature of your complaint
* Complaint Details:
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