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Citizen Complaint Illicit Discharge Reporting Form
Citizen Complaint Illicit Discharge Reporting Form
North York Borough Staff
2022-11-01T20:05:15+00:00
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Name
*
First
Last
Contact Phone Number
*
Date Submitted
*
Time Discharge Discovered
*
Date of Last Rain Event
*
Estimated Quantity of rain in inches
*
Location of Discharge (indicate nearby street intersections, addresses, and/or landmarks for reference):
*
Where was discharge found?
*
Open Ditch
Stream
Pipe Outfall
Other
If Other please describe:
Was water flow observed?
*
Yes
No
Was flow solid or pulsing?
*
Solid
Pulsing
Was a photo taken?
*
Yes
No
Photo Upload
Click or drag a file to this area to upload.
Odor
*
None
Musty
Sewage
Rotten Eggs
Sour Milk
Other
If Other please describe:
Color
*
Clear
Red
Yellow
Brown
Green
Grey
Other
If Other please describe:
Clarithy
*
Clear
Cloudy
Opaque
Was there an oily sheen?
*
Yes
No
Was there garbage/sewage?
*
Yes
No
Please add any additional information to assist in the investigation:
*
Submit
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