Current Page 1 Page 2 Preview Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988.Information may be shared with Departments or Agencies of the Government of Prince Edward Island or the Government of Canada under section 37 (1) (d) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I 1988 for the purpose of complying with enactments, treaties, arrangements or agreements.If you have any questions about this collection of personal information, you may contact the Manager, Environmental Health, PO Box 2000‐16 Fitzroy Street, Charlottetown, PE CIA 7N8 or 902‐368‐4970. Identification Business/Organization Name Contact First Name Contact Last Name Address 1 Address 2 City, Town, or Community Province Postal Code For example C1B 0X1 or 12345 Country Telephone 1 For example 902-555-5555 Telephone 2 For example 902-555-5555 Fax Number For example 902-555-5555 Email Address