Kern County, CA Environmental Health Form Privacy Notice"The information collected on the Environmental Health Complaint Form is primarily used by Environmental Health to investigate the situation reported and to follow-up as necessary. The information may be retained indefinitely in Environmental Health's computer database or may be immediately deleted if the information is incorrect or inappropriate. If any of the information you provide becomes inaccurate for any reason, you are requested to directly contact the Environmental Health office to request changes. The information collected on the Environmental Health Complaint Form is exempt from disclosure under the Public Records Act (Gov't. Code section 6254) and will not be released absent court order." Fill out the following form to file an official report. Click the Submit button at the bottom when you are finished.Information About You(*Required fields)Last Name*First Name*Address Street Address City ZIP Code Email Health Concern Report InformationReason for Report*RestaurantFood VehicleGrocery StoreBakeryMeat Market / DeptDeliHousingSolid WasteHazardous MaterialsBody ArtSwimming PoolDescription of Concern*Report Location Street Address City ZIP Code Specific Directions or Additional CommentsNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.