MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C8CA1E.50A2B810" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Microsoft Internet Explorer. ------=_NextPart_01C8CA1E.50A2B810 Content-Location: file:///C:/025198F0/Citizen_Compaint_Form_CADEP.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" CITIZEN’S COMPLAINT FORM

CITIZEN’S COMPLAINT FORM

 

Please follow up ANY TELEPHONE COMPLAINT with a written complaint.

 

To:   &= nbsp;   California District Mining Office

   &nbs= p;        Department of Environmental Protection

   &nbs= p;        25 Technology Drive

   &nbs= p;        Coal Center PA  15423

 

Date:   = ;            = __________

 

Name:   = ;           ______= __________________________________

Address:  &n= bsp;       ___________________________= _____________

   &nbs= p;            &= nbsp;       __________________________= ______________

Phone:  &nbs= p;          ___________= _____________________________

 

 

Mine Operator:  &= nbsp;         ______________= __________________________

Location of mine: = ;       ______________________________= __________

Name of Mine:  &n= bsp;         _______________= _________________________

 

Nature of problem: ________________________________________________________ ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ____________________________________________________________

 

Action requested from the Department of Environmental Protection

 

____  Cea= se the violation

 

____  Req= uest immediate inspection or investigation

 

____  Req= uest notification of any action

 

____  Req= uest explanation if no inspection is conducted or enforcement action taken

 

____ Other(explain) _______________________________________________________

______________________________________________________= __________________

 

 

____  CONFIDENTIALITY IS WAIVED  = ;            &n= bsp;         ____  I want to accompany inspector<= /p>

 

____  = CONFIDENTIALITY IS NOT WAIVED (I understand I will not be able to accompany inspector)<= /p>

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04/04

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