Pesticide Complaint Form

Our Pesticide Regulation complaint form is here for you to register a complaint about a specific pesticide exposure or unsafe condition within Orange County.

The Best Way to Use This Form is as Follows

Pesticide Complaint Form
  1. Download the PDF Form using the link below.
  2. Complete the form.
  3. Save & Print out a copy of the form on your printer.
    (note: depending on your version of Adobe Acrobat you may not be able to save the filled out form but you can still print it.)
  4. Sign & Date the form.
  5. Fax this completed form to us at (714) 921-2713, or mail it to:
    Agricultural Commissioner
    Pesticide Regulation
    222 East Bristol Lane
    Orange, CA 92865

We will call you as soon as possible to acknowledge our receipt of your complaint and ask for any additional information.

Download Complaint Form Here