Report water quality concerns

* Description of pollution: (such as what is it, how much, when you saw it and possible causes.)

* Location of concern: (include all information that would help us locate the area, including the lake or river name, nearby road crossings, county, subdivision, street address, desription of any structures on the property.)

* Directions: (tell us how we can find it)

Have you notified another agency?
Yes
No

If yes, tell us the agency and contact person:

Your first name:

Last name:

E-mail Address: (Optional, although an e-mail address will expedite out response.)
(i.e. xxxxx@xxx.com)

Mailing Address: (if requesting information)

City:

State:

ZIP Code:

Home Phone Number:

Work phone number:

FAX:

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