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City of Carrollton, TX
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Submitted
Code Enforcement - General Information
TMPCE20240009435
Required information is indicated with an asterisk (*).
Please select the complaint type that most closely describes your complaint.
--Select--
CS Basketball Goal in Street, Alley, Sidewalk or R-O-W
CS Commercial Property Maintenance
CS Dead Vegetation Violation
CS Early Placement - Bulk Waste
CS Early Placement - Containers
CS Fence Violation
CS Garage Sale Violation
CS Graffiti Violation
CS Grass and Weed Violation
CS Home Business Violation
CS Housing Violation
CS Illegal Dumping
CS Inoperable/Junked Vehicle
CS Parking Violation
CS Sign Violation
CS Swimming Pool Maintenance
CS Trash and Debris Violation
CS Tree Limbs and Other Vegetation Violation
DS Commercial Landscape Violations
DS Unpermitted Construction
DS Unpermitted Fence
DS Visibility Clip Obstruction
EQ Industrial Complaints
EQ Light/Noise Pollution
EQ No Food Permit/Illegal Food Vendor
EQ Odor
EQ Public Pool Complaint
EQ Restaurant Complaint
EQ Smoking complaint
EQ Spills and Discharges
EQ Water Conservation
Other Code Enforcement Complaint
RH Hotel/Motel Rental Complaint
RH Multi-Family Rental Complaint
RH Single Family Unregistered Rental
Complaint Type:
*
Describe in detail the nature of your complaint and the alleged violation:
*
Please note, if you know the address of the violation you will be asked to select this later in the process. This information is for the actual place(s) on that address where the violation exists.
Please enter a description of the locality of your complaint that will allow the inspector to easily find the violation (eg. Backyard):
*
Internal Fields
Empowerment Zone:
*
JBL Overlay:
*
Planned Development:
*
Zoning:
*
Flood Plains:
*
Neighborhood Inspector:
*
Waste Collection Day:
*
Payment Method
Paying by Credit Card?:
*
Complaint Received From
Name:
*
Street Address:
*
Home Phone:
*
Email:
*
Establishment Information:
*
Establishment Name:
*
Establishment Street Address:
*
--Select--
Yes
No
Contact Back Needed?:
*
--Select--
Email
Phone
If yes, Preferred Contact:
*
Select Department/Agency
--Select--
Animal Services
Building Inspection
Community Development
Engineering
Environmental Quality
Fire Department
Other City Department
Other Outside Agency
Parks
Police Department
Public Works
External Agency:
*
Nature of Complaint
Illness:
*
Other - Food Quality:
*
Other- NON-FOOD (Odor, No Hot Water, Cleanliness, etc.):
*
Specific Problem/Concern:
*
Laboratory Specimen Info
Type of Food Consumed:
*
How Many Ate Same Meal?:
*
How Many Became Ill?:
*
--Select--
Yes
No
Was Anything Eaten Before or After the Suspect Meal?:
*
Date of Meal:
*
Time of Meal:
*
Time of First Symptoms:
*
Duration of Illness:
*
--Select--
Yes
No
Physician Consulted?:
*
Physician Name:
*
--Select--
Yes
No
Hospital Attended?:
*
Hospital Name:
*
--Select--
Yes
No
Establishment Contacted?:
*
Symptoms Experienced
Nausea:
*
Diarrhea:
*
Abdominal Pain:
*
Fever:
*
Chills:
*
Vomiting:
*
Headache:
*
Describe, if Other:
*
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