Report a Pollution Violation Form

Contact Information

All information is confidential. If you prefer to not supply your e-mail or name it is not required. Setting up a temporary yahoo or gmail account using an alias such as "concerned_citizen" in the name would allow us to contact you if we have further question about what you are sighting.

First Name: Last Name: Email Address:

Incident Details

*Description of Incident: (incl. odors; visual; things observed) *Waterbody: Landmark: Address: Municipality: *County: *State: GPS Coordinates:

Date, Time, & Conditions

*Date Observed: *Time Observed: Source of Pollution:(if known) Weather: Temperature: Water Conditions:

Actions

Photos, Video Taken or other evidence: Samples Taken: Agencies Contacted:(DEC, EPA, etc.)

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