Please fill out this form as completely as possible.
Person Reporting the Violation
First Name:
Last Name:
Telephone:
E-mail:
Violator Information
Violator's Name (person or company):
Address:
City:
Violation Information
Date of Illegal Discharge:
Time:
a.m.
p.m.
Exact information about the location of the offense is very important. If the street address is not known, describe the location as accurately as possible. Example: "Vacant lot on the west side of 201 North Broadway" or "Vacant lot on southeast corner of Broadway and Valley Parkway."
Location of Illegal Discharge:
If a vehicle was involved in the violation, please provide as much information about that vehicle as you can.
License Plate Number:
Make:
Color:
Model:
Provide any other markings on the vehicle, such as business name, phone number, permit numbers, etc.
Please write a brief description of the alleged violation and provide any additional comments about the violation that you wish to submit.
Click the "Submit" button to send your report to the Storm Water Program staff at the Public Works Department.
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