Environmental Complaint

2. 

3. USE THIS FORM TO SUBMIT ENVIRONMENTAL COMPLAINTS WITHIN THE CITY TO THE ENVIRONMENTAL DIVISION
   The City seeks to respond to all complaint within three business days. Some complaints may need to be forwarded to different departments or jurisdictions which may change response times.

   The City seeks to respond to all complaint within three business days. Some complaints may need to be forwarded to different departments or jurisdictions which may change response times.

5. PLEASE ENTER YOUR CONTACT INFORMATION
   This information will not be shared and is use to contact you if more information is needed.

   This information will not be shared and is use to contact you if more information is needed.

7. NAME*

9. ADDRESS*

11. TELEPHONE*

12. EMAIL*

14. PLEASE SELECT THE TYPE OF COMPLAINT*

    1. Air Quality
    2. Hazardous Waste/Materials
    3. Public Health/Mosquitoes
    4. Stormwater
    5. Drinking Water
    6. Other

15. DATE/TIME ISSUE IDENTIFIED OR OCCURED*
    DATE/TIME ISSUE IDENTIFIED OR OCCURED

    DATE/TIME ISSUE IDENTIFIED OR OCCURED

17. PLEASE IDENTIFY LOCATION OF ISSUE*

    Address, Crossroads, Lat/Long

19. PLEASE DESCRIBE THE ISSUE*

21. PLEASE UPLOAD ANY PHOTOS OF THE ISSUE

22. WOULD YOU LIKE A FOLLOW-UP
    -- Select One --NOEMAILPHONE CALL

24. All complaints will be investigated to the extent possible. Sometimes a responsible party cannot be identified. If the issue requires urgency please contact the Environmental Compliance Coordinator at 623.876.4252

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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

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