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Board of Health
· WIND TURBINE IMPACT COMPLAINT FORM
WIND TURBINE IMPACT COMPLAINT FORM
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THE FAIRHAVEN BOARD OF HEALTH
40 Center Street, Fairhaven, MA 02719
BOH@fairhaven-ma.gov
508-979-4022
Location: (effects observed INSIDE a building)
Checkboxes
Checkbox Description
Checkboxes
Checkbox Description
North interior
Basement
South interior
1st floor
East interior
2nd floor
West interior
3rd floor
Windows open
All interior locations
Please provide the following information:
Field Description
Field Data
Required Field
Complainant Name:
required
Email:
required
Complainant Address
required
Complainant Telephone:
Date and time of event:
Duration of event:
Location of event was: (Please check one/and add address in the field provided below)
Residence
Commercial site/building
School
Public area
Nature of event:
Sound
Light flicker
Pressure change
Visual
Other
If you chose other please indicate below:
Describe intensity of above on a scale of 1 to 10 with 1 being no change, 10 being unable to perform normal activities at the location. Describe the intensity for each nature of event that has been checked above.
Impact of observed effects on you:
Sleep disturbance
Loss of appetite
Headaches
Anxiety
Nausea
Ability to concentrate affected
Describe intensity of above on a scale of 1 to 10 with 1 being no change, 5 being uncomfortable, 10 being intolerable (unbearable)
Addition comments:
With whom may this information be shared?
1) Selectmen
2) Fairhaven Wind
3) DEP
4) DPH
5) None
Field Description
Field Data
Privacy: The Board of Health will maintain these records. All personal information will remain confidential. The owner of the wind turbines will be contacted about the nature of the complaints. This information is confidential and will not be shared unless express permission is granted by the complainant.
