Complaint - Template

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Complaint ID - 17717

Irlbeck Farms - 310719425

1465 Fig Avenue Dedham, IA 51440

Guthrie County

FO 4

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Complaint ID:

17717

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
6/3/2014	Visited facility and conducted onsite inspection. No documentation of discharge during inspection.	ERIN OGLE

Comment:

Compliance Tracking

Action Type	Date	Completed Date	Comment	Delete

Multiple Results Found

Field Office Compliance - Complaint

Complaint ID - 17717

Irlbeck Farms - 310719425

1465 Fig Avenue Dedham, IA 51440

Guthrie County

FO 4

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