Illicit Discharge Form

Subject

Your Name (required)

Your Email (required)

Your Phone Number(required)

Today's Date

Time Discharge Discovered:

Date of Last Rain Event:

Estimated Quantity of Rain
inches

Location of Discharge

Where was discharge found?
 Open Ditch Stream Pipe Outfall
other?

Was Water Flow Observed?
 Yes No

Was Water Flow Solid or Pulsing?
 Yes No

Was a Photo Taken?
 Yes No

Upload photo here:

Odor
 None Musty Sewage Rotten Eggs Sour Milk
other odor?

Color
 Clear Red Yellow Brown Green Gray
other color?

Clarity
 Clear Cloudy Opaque

Was There an Oily Sheen?
 Yes No

Was There Garbage/Sewage?
 Yes No

Additional Information to Assist in the Investigation: