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2. Information of Person Submitting Complaint
   We require that certain information is submitted with a complaint for tracking and documentation purposes.
4. Name of person submitting complaint*
   Please submit your name so that we may follow up if any further information is needed.
6. Phone Number *
   Please provide the best number for us to reach you at.
7. Email*
   Please provide your email in event we may need to contact you.
11. Complaint Details
    Please provide as much detail as possible regarding the complaint you are submitting.
13. Category of Complaint*

    Please select the category that most closely fits the nature of the issue.

    1. Surfacing Sewage/Failing Septic System
    2. Water Quality
    3. Foodborne Illness

    1. Animal Bite
    2. Air Quality (Indoor)
    3. Hotel/Motel/Public Accommodation

    1. Odor Complaint
    2. Construction without permits
    3. Other (see description below)
15. Date and Time of Complaint*
    Date and Time of Complaint Start Date

    Date and Time of Complaint Start Time

    —

    Date and Time of Complaint End Date

    Date and Time of Complaint End Time
    Please estimate the start date and end time of the complaint with as much accuracy as possible.
16. Location of Complaint*
    Please provide an address, major intersection, company name, to help us identify the location of the issue.
18. Detail of Complaint*
    Please provide information regarding the complaint.
20. Please upload any photos or files that relate to the complaint
24. 
25. ** Disclaimer **
    Please note that complaints are addressed and investigated in order of severity. Not all complaints lead to legal action. Follow up with the complainant is not guaranteed.
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field