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IMPERIAL WESTERN PRODUCTS <br /> Environmental Health Incident/Complaint Log <br /> Site: County: <br /> Date of Type of Person Date Corrective Measure(s) Date Re- Date <br /> Occurrence Incident* Responsible to Investigated Taken Corrected Inspect Closed <br /> Investigate Y/ <br /> * Incidents may include:complaints against the facility(i.e.noise,odor,flies,traffic,etc.),equipment breakdowns or damage,personal injury to employees or visitors, <br /> etc.If the incident is a complaint,please complete page 2 with name,address,and telephone#of the complainant. <br /> 1` <br />