Skip to Main Content
Do Not Show Again
I Want To...
Select a Category
Air Pollution Control
Americans with Disabilities Act (ADA)
Board of Supervisors
CEO - Tahoe
Child Support Services
Clerk of the Board
Community Development Resource Agency
Contact Placer County
County Executive Office
Health & Human Services - Adult System of Care
Health & Human Services - Animal Services
Health & Human Services - Children's System of Care
Health & Human Services - Environmental Health
Health & Human Services - General
Health & Human Services - Human Services
Health & Human Services - Public Health
OES - Office of Emergency Services
Stormwater Quality Management
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Environmental Health Complaints
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Our Specialists may need to contact you for additional information.
Complainant information is confidential, unless a subpoena requests the complaint form be submitted for legal process.
Address Line 2
Please be as detailed as possible when filling out complaint information. This will help our Specialists respond quickly and appropriately.
-- Select One --
Public Swimming Pool/Spa
Restaurant or Food Facility
Tattoo or Body Art Shop
Sewage on the Ground
Choose the option that best describes your complaint.
Complaint Business Name, if applicable
Address Line 2
Complaint Phone Number
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
Slideshow Left Arrow
Slideshow Right Arrow