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Plumbing or Septic System Complaint Form

Complainant

Information of the individual submitting this form.

Protected by the "Freedom of Information Act"; your identity will be protected from disclosure.

First Name:

Last Name:

Full Address:

Phone Number:

E-mail Address:

Please indicate the type of complaint:

This is a septic system complaint

This is a plumbing system complaint

Both

Location of property complaint

Full Address:

Municipality:

Name of property owner (if known):

Complaint

Please explain your complaint in detail.

Please include any photos or sketches that support your complaint.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Would you like to receive further correspondence regarding the outcome of this complaint?

Yes

Notice of Collection

The personal information you choose to provide on this form is collected under the authority of the Municipal Act, 2001 (as amended) Section 239. The information you provide will be used to investigate the complaint and may be used for contact purposes. Questions about this collection may be directed to the Senior Plumbing and Sewage System Inspector.

Signature of Complainant:

Clear

Date

For further inquiries please contact:
Kirk Johnstone, Senior Plumbing & Septic Inspector directly at 905-373-2619.

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