COVID-19 Public Health Order Business Violation Complaint

COVID-19 Public Health Order Business Violation Complaint

This Form is for Non-Emergencies
This form is for businesses in the unincorporated area of Marin County only.

This is a tip line to report local businesses that are suspected to be out of compliance with local public health guidelines. If your complaint is not business-related (e.g., complaint about a person), you should contact your local law enforcement agency to discuss the nature of the violation and possible action.

If you have a general question, but not a complaint, please direct your question to the COVID-19 response team.

Thank you for your help in keeping Marin healthy.
Name of reporting party *
Phone number of reporting party
(area code) phone number
Email of reporting party *
example@example.com
I prefer to remain anonymous *

Yes No
Name of business or other entity where violation was observed *
Type of business or other entity where suspected violation occurred
Other type of business or other entity where suspected violation occurred *
Address where suspected violation occurred
Approximate address of business or other entity if unknown
Street Address *
City *
State
Zip Code
Types of business violation (check all that apply) *

Lack of Mask Enforcement— Customer Lack of Mask Enforcement— Employees Lack of Physical Distancing Enforcement Business Operation Violation (Non-Essential Business operating) Lack of Sanitation/Disinfection of shared spaces Other Site-Specific Protection Plan (SSP) violations (i.e. failure to post the plan, implement the plan, adhere to the plan)
Enter at least one date/time the suspected violation occurred (approximate if unknown) *
Names of any persons at the business or other entity where violation occurred (if known, or observed from name tags, etc.)
Description of what was observed that may have violated Public Health Orders *

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Photos of violation

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Files allowed: jpg, jpeg, png, tiff, bmp, gif Cancel of
Jurisdiction
Status
Investigator
Case #
Notes

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