Environmental Health Complaint

 Step 1 of 1

Please fill out the form completely! 
 
  • You must leave your name and contact information to validate the concern. 
  • An incomplete form will result in the concern not being investigated. 
 
This form will be used for legal purposes.  Falsifying information is against the law!   

* Denotes a required field

Environmental Health Report of Concern

 
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Children Involved? 
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Please be as specific as possible