Complaint - Template

	Name
Select	DeSousa Livestock LLC
Select	AgVice Samantha DeWitt

Complaint ID - 26811

Desousa Site - 310703961

1091 270th Street Jesup, IA 50648

Buchanan County

FO 1

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Complaint ID:

26811

Date Received:

Date Assigned:

Received By:

Assigned To:

Complainant

Anonymous

DNR Observation

Name:

(F)

(L)

Address:

Phone:

Ext.

Email:

City\State\Zip:

Statement of Complaint:

Complaint Type:

Complaint Location

Sec:
Tier:
Range:
Lat:
Long:

Complaint Resolution

Action Date:

Status:

Compliance Determination:

Responsible Party

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
5/15/2019	Forwarded to David Schmitt State Vet via email.	BRIAN JERGENSON

Comment:

Compliance Tracking

Action Type	Date	Completed Date	Comment	Delete

Multiple Results Found

Field Office Compliance - Complaint

Complaint ID - 26811

Desousa Site - 310703961

1091 270th Street Jesup, IA 50648

Buchanan County

FO 1

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