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2012 APC V.INDEX, PAGE 1 SHELBY COUNTY HEALTH DEPARTMENT POLLUTION CONTROL SECTION 814 JEFFERSON AVENUE MEMPHIS, TN 38105 Telephone: (901) 2229599 FAX: (901) 2229550 MAJOR SOURCE OPERATING PERMIT
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How to fill out Shelby County Health Department Pollution form:

01
Start by obtaining the Shelby County Health Department Pollution form. This form is typically available on the official website of the department or can be obtained in person at their office.
02
Review the instructions provided with the form. These instructions will guide you through the process of accurately and thoroughly filling out the form.
03
Begin the form by providing your personal information. This may include your name, address, contact number, and any other required details.
04
Proceed to the sections of the form that specifically address pollution. This may include questions related to the source of pollution, the type of pollution, and the potential health hazards associated with it.
05
Provide detailed information about the pollution incident or issue. This could involve providing a description of the incident, the date and time it occurred, and any corresponding photographs or evidence you may have.
06
Answer any additional questions or sections on the form related to the pollution incident. This might include inquiries about witnesses, any follow-up actions taken, and your proposed resolution or mitigation plan.
07
Double-check the form for any errors or omissions before submitting it. Ensure that all required fields are completed accurately and all necessary supporting documentation is attached.
08
Once completed, submit the form to the Shelby County Health Department. This can typically be done either online or in person at their office. Follow their specific instructions for submission.
09
Keep a copy of the filled-out form for your records. It may be helpful to maintain an organized file containing all relevant documentation related to the pollution incident.

Who needs Shelby County Health Department Pollution form?

01
Individuals or businesses who have witnessed or are aware of a pollution incident within Shelby County.
02
Residents or property owners who have been affected by pollution and wish to report it to the appropriate authorities.
03
Environmental organizations or advocates who work to ensure the protection of the environment and public health in Shelby County.
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The Shelby County Health Department pollution refers to the reporting of pollutants and contaminants in the local environment.
Any individual or organization that releases pollutants into the environment is required to file the Shelby County Health Department pollution report.
To fill out the Shelby County Health Department pollution report, you must provide information on the types and quantities of pollutants released, as well as any potential health risks associated with the pollution.
The purpose of the Shelby County Health Department pollution report is to monitor and regulate the release of pollutants into the environment to protect public health and safety.
The Shelby County Health Department pollution report must include details on the types of pollutants released, the quantity of each pollutant, the sources of pollution, and any potential health hazards associated with the pollution.
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