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Air Pollution Complaint
This form has been modified since it was saved. Please review all fields before submitting.
Your Email Address
Your Phone Number
Your Street Address
Source of Air Contaminants
Information about the source of air contaminant or location at which the air contaminant was observed (if other than your home).
Do you know the name of the person or the company responsible for the air contaminants?
Name (if Known) of Person/Company Discharging the Air Contaminant to the Atmosphere
Company Name (if applicable)
Phone Number of Responsible Party
Date & Time of Observation
Was the emission of air contaminants continuous or intermittent at that time?
Has it occurred before?
Provide more information about the air contaminants or emissions.
Type of Emission
Direction the Wind Was Blowing from
-- Select One --
Complaint or Violation Report
Were you impacted by the air contaminate discharge or are you reporting a potential violation of air pollution regulations?
Complaint or Violation Report
Yes, I was impacted by the emissions
No, I am reporting a possible air pollution violation
Describe the air contaminant problem and how you are impacted:
Describe the air contaminant problem that is a potential violation:
Upload & Attach Photos or Documents
Your completion of the following is required:
Will you testify in court?
Notice: The District will not voluntarily disclose the Complainant's (your) identity unless the case goes to court in which case disclosure may be required. However, the District cannot guarantee that the identity of the Complainant will not be deduced due to the circumstances, particularly if the source of air contaminants is nearby and/or the Complainant has had previous interactions with the investigated party. The District may find that some private disputes are not resolvable through District enforcement.
I have read the statement and to my knowledge the entries I have made are truthful and complete.
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