891 Mountain Ranch Road -
San Andreas, CA 95249
Phone: (209) 754-6326 Fax: (209) 754-6328
"Compliance Through Education"
Renter's Information (If Applicable)
Type of Violation
NOTE: The following information is required in order to submit a compliant. (This information will be kept confidential)
When Submitting an on-line form, typing your name below is equivalent to a signature.
Select the "Submit" button only once. If you are not re-directed to the "Thank You" screen after clicking submit, please verify you have completed all the required fields. Errors will be shown to the right of the required field.