Information about the suspected violation Please provide as much information as you can in the form below. Asterisks (*) indicate required fields, but if you do not know the name or address of the alleged violator, the form will accept Unknown . * * * * Please Select Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territories Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming * Date of Incident:
Your Contact Information You are not required to provide your contact information in order for EPA to review your tip or complaint. However, if you do not provide contact information, EPA may be unable to contact you for additional information that may be needed to determine whether or not an investigation in warranted. If you do provide contact information, this information may be used to initiate follow-up communications with you and may be shared by EPA with appropriate administrative, law enforcement, and judicial entities engaged in investigating or adjudicating the tip or complaint. Please review the EPA Web Privacy Policy for more information. Your name: Your email: Your phone: Your address: Your city: Your state: Please Select Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territories Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Your zip code:
*
Specific driving/walking/boating directions (from nearest intersection, main road, waterway or supply navigational coordinates, if necessary): *
When you are finished filling out the form, use the Send Comment button to activate your complaint. Thank you for your help with protecting the environment.
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OMB Control No. 2020-0032
The public reporting and recordkeeping burden for this collection of information is estimated to average ½ hour per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
