Berkeley County Health Department

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Health Department

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BERKELEY COUNTY

Name - Person requesting the investigation: *

Phone - Person(s) Responsible for the Condition: *

Location (be specific): *

Date and time *

When? *

Have you reported this condition to the person(s) responsible? *

Yes

Name - Person(s) Responsible for the Condition: *

I herein request an investigation of the public health hazard or nuisance described below: *

Email - Person requesting the investigation: *

Address - Person(s) Responsible for the Condition: *

Complaint Form (Online)

Please fill out this online complaint form for any concerns dealing with public health violations.

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Environmental Services

Not only do we provide programs for your health, we also ensure your surroundings are safe.

Address - Owner of Property (if different):

Name - Owner of Property (if different):

Have you reported this condition to the person(s) responsible? *

Yes

Address - Person requesting the investigation: *

What Agency?

Phone - Person requesting the investigation: *

How long has the condition existed? *

Phone - Owner of Property (if different):

By making this request for an investigation, I acknowledge that the health department may take all necessary steps consistent with the appropriate laws to investigate and effect correction if such is warranted. Such action may involve referral to other agencies or legal action that may require the need for court appearance and testimony to collaborate the conditions stated in this complaint. *

Yes, I acknowledge

No, I do not acknowledge

Was this condition reported to another agency? *

122 Waverly Ct, Martinsburg, West Virginia 25403

8:30AM - 4:30PM M-F, (304) 263-5131