AHTD STORM WATER COMPLAINT FORM
Please fill in the following information about your complaint
*asterisk indicates information that is required, all others are optional
*Type of Violation-Select a choice from the list below Dumping into storm drain or ditch Discharge from pipe Sediment from construction site Industrial or municipal waste Sewage or septic tank discharge Other (please describe below)
*Specific description of Violation
*Address where violation occurred or clear directions to violation location/driving directions. Please be as exact as possible.
Name, address, and telephone number of the individual, company,
business, or government entity responsible for the violation, if known.
Information about You:
(Note: Giving us your name, address, phone number and/or e-mail address is optional -- you do not need to provide them in order to send us your questions, comments or complaints. However, if you do not, we will not be able to provide you with any follow-up information.
Your name
Your telephone number, including area code.
Your e-mail address
Note: Click "Submit Now" only ONCE.
THANK YOU!