Environment Complaints Form
Thank you for taking the time to submit this complaint, and for helping the Health Department by informing us of the following issue.
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Required Fields(s)
Problem Address:
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Type of Complaint:
Please Select One ---->
Request for rodent abatement
Insect/vermin infestation
Food contamination
Report of Foodborne illness
Accumulation of garbage, trash, debris, litter on ground
Animal nuisance
High grass/weeds
Request for lead inspection
Sewage back up/standing water
Illegal Food Operation
Restaurant/store dirty
Unsanitary living conditions
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Full Name:
Address:
City:
State:
Please Select One ---->
Ohio
Pennsylvania
Michigan
West Virginia
Indiana
Kentucky
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Zip Code:
Phone Number:
(###) ###-####
Email Address:
Description of Complaint:
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