2. A. GENERAL COMPLAINT DATA
4. Facility Name*
   -- Select One --Central Landscape Supplies Ltd.GFL Environmental Ltd.Fisher Road Recycling
5. Type of Complaint*
   -- Select One --OdourNoiseDustOther
7. Complaint Location*
   address or nearest cross roads
8. Complaint Reported Via*
   -- Select One --CVRD Online Complaint FormEmail (from the CVRD)Email (from the Complainant) Phone/SMS (from the Complainant)Other
10. Date of Complaint Incident
    Date of Complaint Incident
11. Time of Complaint Incident
    Time of Complaint Incident
12. Date Complaint Received by Licensed Facility
    Date Complaint Received by Licensed Facility
15. Time Complaint Received by Licensed Facility
    Time Complaint Received by Licensed Facility
16. Time Complaint Investigated by Licensed Facility
    Time Complaint Investigated by Licensed Facility
17. Date Complaint Investigated by Licensed Facility
    Date Complaint Investigated by Licensed Facility
19. B. ODOUR SPECIFIC COMPLAINT DATA
21. Odour Intensity
    -- Select One --barely noticeablenoticeablevery unpleasantunbearable
22. Odour Tone

    List the odour description provided by the complainant.

    1. bakery (roasty/malty/buttery)
    2. dead animal (putrid)
    3. earthy/musty/mouldy
    4. fecal/sewage/manure
    5. fruity (soapy/citrus/green)
    6. fuel/gas (rubbery/glue/mothballs/shoe polish/chemical)
    7. nitrogen/ammonia (fishy/urine)
    8. pine/lemon/grassy/terpene
    9. rancid/putrid (yeast/sour milk/decay)
    10. sweet (nail polish/solvent/garbage can)
    11. sulfur/cabbage/garlic (rotten egg/skunk)
    12. other - describe
23. Odour Tone / Description - Other
    Add any other odour description provided by the complainant
25. Venting Index at Time of Complaint
    -- Select One --good/goodgood/fairgood/poorfair/fairfair/goodfair/poorpoor/poorpoor/fairpoor/good
26. Venting Index
    venting index

    Use the above link and scroll down to "SRN VAN ISLD"
27. Other Odour Sources
    Other likely sources of odour near the complaint location that match the odour description.
29. Temperature Degree in Celcius*
30. Wind Direction at Time of Complaint
    -- Select One --northnorthwestnortheasteastwestsouthsouthwestsoutheast

    The wind was blowing FROM
31. Weather at Time of Complaint*
    -- Select One --sunnyovercastfog or drizzlerain
33. C. OPERATIONAL SPECIFIC DATA
35. Operations at Time of Complaint*
36. Odour Investigation*
    Describe how the odour was investigated.
38. Was the Complaint Substantiated? *

    1. Yes - odour likely from facility
    2. No - odour not likely from facility
    3. Possible - odour may have come from facility
39. Complaint Investigated by
    Name of facility staff person
41. Weather Information Source
    E.g. weather station at facility, Ministry maintained weather station, school weather station, etc.
43. Corrective Measures Taken
    If applicable, describe what measures has been taken to reduce future complaints from the facility of this kind.
45. Report submitted by
    Name of staff person
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field