BUSINESS EMERGENCY CONTACT
FORM
THIS FORM MUST BE FILLED OUT
COMPLETELY
Name of Business
Business Street Address Suite/Apt. # City State Zip Code
Name of Business Owner (Company and/or Individual – Please print)
Business Phone Emergency Phone Cell Phone E-mail
Type of Business (Explain) Size of Business in Square Feet or Dimensions
Alarm System: □ Yes □ No If yes, Alarm system must be registered with the Chamblee Police Department and a Permit is required.
Hazardous or flammable materials stored on site? □ Yes □ No If yes, please list:
IN CASE OF EMERGENCY AFTER HOURS, PLEASE CONTACT (List in the order to be called):
First Contact
Address Suite/Apt.# City State Zip Code
Home Phone Cell Phone Email
Second Contact
Address Suite/Apt.# City State Zip Code
Home Phone Cell Phone Email
Third Contact
Address Suite/Apt.# City State Zip Code
Home Phone Cell Phone Email
Name of Building/Property Owner
Address Suite/Apt.# City State Zip Code
Home Phone Cell Phone E-mail
City of Chamblee City Hall
5468 Peachtree Rd. | Chamblee, GA 30341 | 770-986-5010| chambleega.gov
