Report Water Pollution

Last Updated: December 15, 2017

Please use this form to report any water pollution or issues observed. In cases of large spills or an emergency please do not use this form, but call 9-1-1.

*Denotes a required field.

Your Contact Information

If you wish to remain anonymous, leave all fields blank.

If you choose to not provide a means of contact, city staff may be unable to reach you to determine whether or not an investigation is warranted.

If you do provide contact information, this information may be used to initiate follow-up communications with you regarding your water pollution observations.

Name (First Name, Last Name)

Phone

Location of Event *

Include specific driving/walking directions (from nearest intersection, main road, waterway or supply navigational coordinates, if necessary).

Description of Incident *

If known, please include a description of the type and quantity of material(s) involved. Please indicate if surface waters have been affected.

Date of Event *

Month

Day

Year

Time of Event *

Hour

Minute

*approximate time is okay

Is the incident still occurring? *

Yes

Have any other Federal, State, or Local Agencies been notified through additional means (phone call, email, etc.) Please answer either Yes or No. If Yes, please list: *

Water level of stream, if in or near stream

If the stream smelled, what did it smell like (please describe)

Other Conditions & Additional Comments

Please describe other conditions, as you are able (Was it windy? Do you remember wind direction? When was the last rain event? Etc.)

Information about the person, company or entity responsible for the pollution incident:

If you do not know who is responsible for the pollution, please leave the following fields blank.

First Name, Last Name

Company Name

Phone Number

Address

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Report Water Pollution