West Bengal Pollution Control Board
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PUBLIC GRIEVANCE

Grievance Form
 
Name of the Complainant :*  
 
Address of the Complainant
District :* Police Station :*
 
Municipality : Panchayat :
 
Name of the Village/Town :* Premises No. & Name of Road :
 
Post Office :* Pin Code :*
 
Name of Complained Against: *
 
Address of the Complained Against
District :* Police Station :*
 
Municipality : Panchayat :
 
Name of the Village/Town :* Premises No. & Name of Road :
 
Post Office :* Pin Code :*
 
Type of Complaint (Complain Description) :*
 
Nature of Complaint :* Air : Water : Sound : Waste : Others :
 
Complaint Receipt Date: [DD/MM/YYYY]*