Delaware County Pond Complaint Form

Date:

Staff Initials:

Address of Complaint:

Complaintant Name:

Phone:

Complaintant Address:

Complaint Type:

☐ Water Drainage

☐ Safety Concerns

☐ Overgrowth

☐ Pests

☐ Other:

Comments about Complaint:

Office Use Only

(Please include inspection date, comments, and recommended course of action)

Building Commissioner/Floodplain Administrator:

Stormwater Management:

Health Department:

County Surveyor:

County Engineer: