Drinking Water and Groundwater Bureau Complaint Form

 
The NH DES Drinking Water and Groundwater Bureau regulates public water systems, NH accredited laboratories, youth recreation camps, water use facilities; well construction, maintenance, and decommissioning standards; and public water system certified operators. To submit a complaint to the Drinking Water and Groundwater Bureau, please fill out this form. For additional information, please visit the Drinking Water and Groundwater Bureau page: click here. For questions please contact the Drinking Water and Groundwater Bureau at 271-2513. Please consider completing each question so that we may contact you regarding your complaint.
1. Contact Information (person submitting this complaint):
2. Would you like your information to remain confidential? Please be advised that DES may be required to reveal this information if the case proceeds to an administrative trial or hearing.
3. Type of Complaint/Incident. Please select the type of DWGB complaint:
4. Complaint Against:
5. Provide a description/summary of the complaint or incident, including when the incident occurred and if it's still occuring, and how you became aware of the situation.
6. Have you contacted the Facility/Public water system/Individual regarding your complaint? If so, please identify who you spoke with, when, and summarize the conversation.
7. Have you contacted or filed a similar complaint with another state agency or municipality? If so, please identify who you contacted, when, and the outcome.
8. Have you been in contact with DWGB staff regarding your complaint before filling out this form? If so, please identify who from DWGB you've been in contact with and the outcome.
Your complaint will be submitted to the Drinking Water and Groundwater Bureau. If you would like to retain a copy of this form, please print the document prior to clicking the submit button [press and hold "Ctrl" and "P" (or "Command" and "P" for Macs), to open the print dialogue box]. DWGB staff will contact you regarding your complaint, unless you did not provide contact information.
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