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COMPLAINT/VIOLATION REPORTING FORM
Use this form to report a violation of Colorado Rules or Statutes.
To read
Colorado Rules
or
read
Statues
24-33.5-1204.5, C.R.S
.
Contact Information
Your Name (First & Last)
Your Phone Number (including area code)
Your Email
Would you like to be contacted?
Yes
No
I am reporting a Complaint/Violation for the following (please check all that apply)
Casino
Fire Inspector
Fire Suppression Systems Contractor
Fireworks/Pyrotechnic Display Operator
Fireworks Retail Stand
Fireworks Wholesaler
Health Facility
Hotel/Motel
Public Schools (PK-12), Charter Schools & Junior Colleges
Reduced Ignition Cigarettes
Sprinkler Fitter
Waste Tire Facility
What Type of Registration Do They Hold?
Commercial, Civil & Residential
Residential
Backflow
Underground
Unknown/None
What Type of Registration Do They Hold?
Inspector I
Inspector II
Inspector III - Plan Reviewer
Unknown/None
Registration/Certification Number (if known)
Name of Person that is Subject of Complaint/Violation (First & Last)
Business Name that is Subject of Complaint/Violation
Describe the violation in as much detail as possible (time, date, location, etc.)
Please attach any documentation you may have in regards to the violation (pictures, letters, etc.)
Contact Information