Your Name (required)

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    Today's Date

    Time Discharge Discovered

    Date of Last Rain Event:

    Estimated Quantity of Rain (inches)

    Location of Discharge

    Where was discharge found?

    Open DitchStreamPipe Outfall

    Other?

    Was Water Flow Observed?

    YesNo

    Was Water Flow Solid or Pulsing?

    YesNo

    Was a Photo Taken?

    YesNo

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    Odor

    NoneMustySewageRotten EggsSour Milk

    Other Odor?

    Color

    ClearRedYellowBrownGreenGray

    Other Color?

    Clarity

    ClearCloudyOpaque

    Was There an Oily Sheet?

    YesNo

    Was there Garbage/Sewage?

    YesNo

    Additional Information to Assist in the Investigation