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i Form 4400-277 (10/111 - <br />F C O t dnr.wi.govftopic(was e/SHwCF/ProcessMessage asp �7 <br />Thank You! <br />The Following information was sent via email: <br />Solid Waste or Hazardous Waste Complaint <br />Form 4400.277 (10/11) <br />State of Wisconsin <br />Department of Natural Resources <br />Waste and Materials Management Program <br />PO Box 7921, Madison, WI 53707 <br />dnr.wi.gov <br />Notice: Complete this form to voluntarily report a solid waste or hazardous waste complaint to the Department of Natural Resources for follow-up. Personal <br />information collected will be used to investigate the incident and may be provided to requesters to the extent required by Wisconsin's Open Records Law [ss <br />19.31-19.39, Wis. Slats.]. <br />Instructions: Please provide the information requested below. You are not required to fill in section A, but contact information almost always makes investigation <br />of a complaint easier. Without the contact information for the person making the complaint and the phone number for the person being complained about, we <br />may not be able to adequately follow-up. <br />If this is an emergency spill, call Wisconsin's 24-hour Hazardous Substance Spill Hotline: 1.800-943-0003. <br />:4♦ • 0 <br />First Name: Jason <br />Last Name: Towne <br />Address: <br />7410 County Rd K <br />City: <br />Siren <br />State: <br />WI <br />Zip: <br />54872 <br />Telephone: <br />715- 34 9-210 9 <br />Email: <br />Jtowne@burnettcounty.org <br />Monday, Jun 25, 2018 01:26 PM <br />