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Fire - Complaint - File Complaint
Fire - Complaint - File Complaint
QUESTIONNAIRE
Please indicate the nature of your complaint
*
Fire Code Enforcement / Registrations / Inspections
Fire Department Activity
Fire Protection System Contractor
Training/Certifications
Please select a Training/Certification complaint type:
Fire Department / Fire Academy / Training Location
Name of Individual
Other - Specify your reason
Please indicate Fire Code Enforcement complaint type
Concern about Fire Code Official
Fire Code Violation as a Business
Fire Protection System Impairment
Other - Specify your reason
Please enter the name of the Fire department/fire academy/training location
*
Please include the name of the individual
*
Fire Department Team
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Contractor Company Name
*
Contractor / Employee Name, if known
*
Permit Number, if known
*
Member Name
*
BUSINESS LOCATION
County
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Municipality
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Fire District
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Property Interest
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Business Name
*
Street Address
*
Building
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COMPLAINT DESCRIPTION
Please fill in the description box below the exact nature of the complaint (ex: I noticed the fire alarm box had no power)
*
*
Have you filed additional complaints regarding this issue with other individuals or agencies regarding this complaint?
Have you filed additional complaints regarding this issue with other individuals or agencies regarding this complaint?
No
Have you filed additional complaints regarding this issue with other individuals or agencies regarding this complaint?
Yes
If Yes, please list who
*
COMPLAINT CONTACT INFO
Do you wish to remain anonymous?
Do you wish to remain anonymous?
No
Do you wish to remain anonymous?
Yes
Organization Name
*
First Name
*
Last Name
*
Business Phone
*
Mobile Phone
*
Email
*
*
Address Line 1
*
Address Line 2
*
Address Line 3
*
City
*
State
*
Zip Code
*
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