Report Violators

EVIDENCE OF NON-STORMWATER DISCHARGE WAS FOUND:

Select One During street sweeping and /or stormdrain maintenance In response to a citizen complaint During inspection or patrol of the stormdrain systems By notification from another agency or department

DISCHARGE WAS FOUND IN OR AROUND:

Select One Stormdrain inlet Street Gutter or open concrete drainage Ditch or Culvert Manhole Pump Station Creek, pond, wetland or other waterway Other Other Explanation >

APPROZIMATE LOCATION OF DISCHARGE:

Location Address: > Creek Name (If known) >

DESCRIPTION OF MATERIAL FOUND:

Select One Automotive (oil, gasoline, antifreeze, etc Paint (of any kind) Swimming pool water Garbage Sewer water Dirt/erosion material Concrete spoils Construction spills Other Unknown Other Description >

General Description of Incident >

RESPONSIBLE PARTY INFORMATION (Suppy all information known)

Name > Address >

Vehicle Make > Vehicle Color > Licence Plate >

REPORTING PARTY INFORMATION:

I request that my identity as the reporting party be kept confidential

I do not request that my identity as the reporting party be kept confidential

(If you would like confirmation that your report has been received and/or a follow up phone call, please enter your email address and contact information.)

Your First Name: Last Name Email Address:

Street Address:

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