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CALL and COMPLAINT LOG
Division of Water Resources - Animal Waste
Winston-Salem Regional Office
Date Received: Z j 2 I a O I
Time Received: 9 . d4 AM
Staff Receiving call: e U
Facility Name: iE E Fo y-MS �$ �•: 1 n�)
Permit Number:
Contact Name: U h� e�
Contact Phone/Email:
Comments/Description:
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Date Investigation Began: /J/
Date Investigation Closed:
Was a violation documented? Yes or o
Responsible Party:
Address:
Follow-up Required: Yes o No — LA-) � � � tr-e1L' FEZ V� � � OL+e- E,4J t e-
Date and Type of Inspection(s) Conducted:
Result of Complaint Investigation: