Stormwater

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Email

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Name*

First Last

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Address/Location*

Date Pollutant was Observed:

Time Pollutant was Observed:

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Do you know the person/business responsible? If so, please answer in the box below:

Person/Business Responsible. Did you see a logo?

License Plate Number:

Please select one or more of the following:

Accidental Spill

Intentional Spill

Strange Substance Discharge

Grass Clippings in Street

Construction Soil Tracked Offsite

Concrete Truck Washing onto Ground or Street

Stormwater Inlet not Draining

Flooded Road

Drainage Problem

Please explain the situation to the best of your ability:

Upload pictures of the incident and/or responsible party:

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